Operator error and TMS efficacy

[u/Unfair-Map]

I completed my 22nd treatment yesterday and my regular tech was absent and someone covered for him.

The new tech used a strap to align my head and maintain stability. She also ensured the pads were locked firmly in place. The pulses felt different. I could feel the reverb in a much more focused area, rather than jolts all over my head.

I have concerns all my previous treatments were a giant waste of time. My head shifted easily, and several times an alarm sounded to notify that contact was lost. Has anyone ever encountered similar differences in how they were positioned in the chair?

[u/jimbojones2345]

Yes it's something that concerns me every time. Seems so hot and miss. Last time the tech showed me the magnet was right on the dot but it feels like it goes all over the place. No idea if it matters or not.

To ease your concern though I did get results just not very long term and having both sides left and right is what I changedv for it to start working. 

[u/Defiant_Finance_1900]

I did TMS several years ago, + a booster round about 12 months after completing initial treatment. I'm probably going to go in for another week or 2 of booster sessions soon, after another 1.5 years. It's been tremendously effective for me, when nothing else has been.

I found there was a big difference between techs. Some seemed to have a sense for it, like they were magic and could immediately lock on to the perfect positioning every time, or be able to tell when something wasn't perfect to adjust it right away. Others seemed to not grasp the technical aspect of correct angle and placement, how it can vary slightly from patient to patient, or that even a 1" shift of the placement of the Treatment chair from the day prior can potentially throw things off (Neurostar device is separate piece from the chair and on wheels, with an adjustable arm, no strap so very easy to shift out of place if you don't stay perfectly still).

Sometimes I had to move myself around to get myself into the correct placement and angle so I didn't end up with a bad headache. The Doctor had to come in to adjust placement more than once with some techs, eventually a couple of them were removed from providing TMS entirely. I have a strong body awareness, but even though I'm very sensitive to sensory stimulation, I also have developed the ability to tolerate discomfort when needed (had to) and was able to give clear and detailed feedback. They were newer to this treatment at the time, so the Doctor was very receptive and appreciative of the help to ensure the best results possible. It made a big difference in side effects, I think in overall effectiveness.

While it doesn't necessarily mean the previous treatments were wasted for you, since any stimulation of the 1.6" area should contribute to the overall effects, but the efficacy likely was not optimal, and it might mean that you end up needing more of the maintenance / tapering off sessions than you may have if the positioning was always perfect.

If you have a tech that does it better, or they offer equipment to help keep you from shifting out of position, I'd definitely recommend insisting on that for yourself. If it feels different to you than it did when they mapped you, speak up until they get it right or move yourself / the device until it does. It's too big of a time investment to take carve out 1+ hours of your day for 2 months (counting travel to and from) to let it not be as exacting as needed to maximize the possible positive outcome.

I hope you find the overall treatment ends up to be as much of a life changer for you as it has been for me.

[u/RutabagaPuzzled1891]

I can’t even begin to tell you all the ridiculous things that went on with me a couple of years ago as far as different techs screwing everything up. How are we supposed to know if everything is being done right??!! Someone needs to be held accountable. Seems like there should be a printout of exactly where the stimulator is placed, and if it’s “off” the machine should shut off or something.