Starting a new treatment can be daunting, especially when faced with so many clinics to choose from. As the patient, you should be informed and choose the best treatment facility for your health. But how do you know where to begin?
After a cursory search for ‘transcranial magnetic stimulation near me,’ you may have a shortlist of TMS facilities. Before scheduling your first TMS therapy session, you should meet the providers and go over a list of questions, like this one to determine which facility is right for you.
1. Am I a Good Candidate for TMS?
This should be one of the first questions you ask your doctor. You want to make sure you understand why you are getting referred for TMS therapy and your expected treatment outcomes.
Compared to other antidepressant treatments, TMS is the newcomer, receiving FDA approval in 2008. Researchers are still conducting studies to investigate the variations in treatment outcomes. Current data suggest concurrent use of antidepressants with TMS is producing better responses. However, every patient is unique, you should discuss your treatment-resistance level and ask what that will mean for your treatment plan.
2. What Could Exclude Me from TMS Therapy?
Your doctor should cover any potential issues with you during your initial consultation as there are also several exclusionary factors for TMS:
- Bullet fragments or shrapnel in or near your head
- Stents in the neck or head
- Aneurysm coils or clips
- Deep brain stimulators
- History of seizure disorder
- Any other objects or metal implanted in the neck or head that are not MRI safe
3. What is Your Background and Experience with TMS?
It is always a good idea to ask about your provider’s education and experience. Despite its over 30 year history, TMS is up-and-coming in the realm of clinical practice. Many doctors did not learn the treatment method in medical school, so you could ask how they trained in the field. Asking how many cases they see in a year is an excellent way to gauge their expertise. While everyone needs to learn somewhere, you have a right to know if you are the doctor’s first or thousandth patient.
4. What are Your Patients’ Outcomes?
Your provider should be able to provide information on their patient outcomes. Success stories are great, but you want to know how many of their patients achieve remission, experience setbacks, or have side effects. If they cannot provide outcomes or the results are unfavorable, you may want to seek a second opinion.
5. Who Will Administer My Treatment?
A psychiatrist is mandated to prescribe and oversee TMS treatment delivery during a patients care continuum. But some practices are so large that you get passed around to a different provider or technician every visit. You want to know if you will be seen by the same provider or have the same few technicians once treatment is underway. If a problem should arise, will you be seeing the same provider or someone that isn’t familiar with your case? Reevaluations every few couple of weeks during your treatment are standard, so you should ask if your provider conducts those or not.
6. What Happens During My Treatment?
Many patients feel more at ease walking into their first treatment session if they know what to expect. Ask your provider to explain what you can expect to do and experience when you are there.
In our clinics, you will remain awake and relax in a reclined treatment chair. You can listen to music or watch television if you prefer. The TMS machine will deliver magnetic pulses to areas of the brain that regulate mood through a coil placed on your scalp. You may feel a tapping sensation with the pulse administration. Once you complete your treatment, you can immediately return to your normal activities.
7. What TMS Machine Does the Practice Use?
There are many different types of TMS systems with varying capabilities. For example, some can deliver treatment in three minutes or less, while others utilize a navigational system to calculate the exact coil placement. Other machines may use manual measures that can be highly accurate, but are also more susceptible to user error. It is important to know the training of the staff you are working with to account for this. While you don’t need to be an expert in every TMS machine out there, you should learn some basics to make sure you are getting the more recent technology for your treatment.
8. Are There Any Side Effects?
As far as antidepression treatments go, TMS has the least side effects; antidepressants can cause lethargy, dry mouth, weight gain, GI upset, and sexual dysfunction. The most commonly reported side effect from TMS is headaches, which can be treated with over-the-counter pain medication and subside throughout treatment. Painful scalp sensations can occur due to the coil positioning. TMS machines can produce a loud noise like an MRI machine, so you can wear earplugs during treatment to prevent any collateral damage to your hearing.
9. Will My Insurance Cover My Treatment?
While most insurance companies will cover TMS treatment, you still want to ensure that your chosen provider will work with your insurance. You may have co-pays or a deductible you have to meet, so be sure to ask about your plan specifically to know what you will have to pay out of pocket.
Ultimately, doctors are here to guide you in your choice, but only you can decide where you should get your TMS treatment. Doctors should be willing to answer any questions to put you at ease with your choice. If they are easily offended, they may not be the best choice for you. Be an active participant in your health by researching TMS treatment centers ahead of time and advocating for yourself.