calmare

[epidural man]

Anybody using Calmare?

We just got the machine in our clinic....lots of jokes about it flying around here.

But who knows, maybe it works...that would be AWESOME!

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[Ligament]

Anybody using Calmare?

We just got the machine in our clinic....lots of jokes about it flying around here.

But who knows, maybe it works...that would be AWESOME!

The rep has been hitting my office manager up hard to pitch it to me. I don't see how it is any different from hundreds of other electric current miracle machines pitched over the years. How is it different?

How are you billing for it? Does insurance cover, or out of pocket expense? if out of pocket, how much do you charge?

I'm curious, but very very skeptical.

 

[epidural man]

The rep has been hitting my office manager up hard to pitch it to me. I don't see how it is any different from hundreds of other electric current miracle machines pitched over the years. How is it different?

How are you billing for it? Does insurance cover, or out of pocket expense? if out of pocket, how much do you charge?

I'm curious, but very very skeptical.

Well the company on their website has a powerpoint that will dispell all your skeptisicm. They have a graph that shows that all the patients that use it become completely pain free.

I have no idea about billing or insurance - as of right now, it is sitting in the corner collecting dust.

 

[PMR 4 MSK]

Here's what I typically see/hear from pts regarding new pain technologies:

Me: There is this new device available that has a chance to alleviate your pain.

Pt: Bring it on doc! I'll do anything to help this pain.

Me: It won't be covered by your insurance and might cost you $50 - 100 per month.

Pt: Oh hell, doc, I can't afford that! Just gimme some o' them Norco's and I'll just suffer with this pain.

 

[jesspt]

I got on the web site and can't find any information regarding the parameters of the device, i.e wave form, direct or alternating current, intesity, etc., so I can't tell if it is actually different than a traditional TENS unit or not. They have done some research, and it is apparently being studied at Viginia Commonwealth and the University of Wisconsin.

http://www.ncbi.nlm.nih.gov/pubmed/12555009

http://www.sciencedirect.com/science/article/pii/S0885392411002648

http://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2005N07A0479

Not exactly the highest quality evidence, but apparently a more tightly controlled trial is on the way:

http://www.med.wisc.edu/news-events...study-scrambler-therapy-for-pain-relief/32658

 

[facetguy]

My bet is that this machine is like all the others that come down the pike (H-wave, various microstim units, laser, etc.). It may help some patients to varying degrees but it won't turn out to be a miracle. And, if it's classified as experimental, insurance won't cover it and very few patients will pay out-of-pocket for it (as suggested earlier).

Kudos to the manuf for at least conducting some studies.

 

[emd123]

Anybody using Calmare?

Yes. Try it lightly battered and flash fried with the marinara sauce. Umm. Tasty.

 

[facetguy]

Yes. Try it lightly battered and flash fried with the marinara sauce. Umm. Tasty.

Hey! Watch it, buddy!

 

[emd123]

Hey! Watch it, buddy!

I'm sorry. I would like to formally apologize to any of those in the Cephalopod community that I may have offended. I never intended to imply that "Calmare" is anything less than "fully equal" to all other appetizers (I'm sorry, I meant "hors d'oeuvres"!! )

 

[rrtzrealmd]

...you might find the inventor's website interesting:

www.deltard.com

...isn't it fascinating?...especially the machine he invented to cure cirrhosis, remove scars, and reverse the effects of old-age by using electric currents to reverse the body's "entropy"...how about them apples?...and don't neglect to look at the page where he tries to sell you one of his "special" fans autographed by himself -- practically guaranteed to become a valuable collectible one of these days...once the world realizes what a genius he is...

...or you may want to look at some of his writings as well:

http://www.smj.org.sa/PDFFiles/Aug04/Delta20040158.pdf

http://www.nutritionj.com/content/3/1/9/comments

...kind of funny how he claims a "MD,PhD" in one paper and then a "MD,DSc" in another paper...especially when he doesn't provide a copy of his CV on his website and nowhere mentions his educational background...even more especially when you consider that it looks like he was busted by Italian police for practicing medicine without a license back in 1995 at which time he was using one of his "electric" therapy devices to treat AIDS patients:

http://translate.google.com/transla...09/16/dario-bellezza-non-ho-aids.html&act=url

 

[lobelsteve]

...you might find the inventor's website interesting:

www.deltard.com

...isn't it fascinating?...especially the machine he invented to cure cirrhosis, remove scars, and reverse the effects of old-age by using electric currents to reverse the body's "entropy"...how about them apples?...and don't neglect to look at the page where he tries to sell you one of his "special" fans autographed by himself -- practically guaranteed to become a valuable collectible one of these days...once the world realizes what a genius he is...

...or you may want to look at some of his writings as well:

http://www.smj.org.sa/PDFFiles/Aug04/Delta20040158.pdf

http://www.nutritionj.com/content/3/1/9/comments

...kind of funny how he claims a "MD,PhD" in one paper and then a "MD,DSc" in another paper...especially when he doesn't provide a copy of his CV on his website and nowhere mentions his educational background...even more especially when you consider that it looks like he was busted by Italian police for practicing medicine without a license back in 1995 at which time he was using one of his "electric" therapy devices to treat AIDS patients:

http://translate.google.com/transla...09/16/dario-bellezza-non-ho-aids.html&act=url

Thank you detective.

 

[Jcm800]

bravo!

...you might find the inventor's website interesting:

www.deltard.com

...isn't it fascinating?...especially the machine he invented to cure cirrhosis, remove scars, and reverse the effects of old-age by using electric currents to reverse the body's "entropy"...how about them apples?...and don't neglect to look at the page where he tries to sell you one of his "special" fans autographed by himself -- practically guaranteed to become a valuable collectible one of these days...once the world realizes what a genius he is...

...or you may want to look at some of his writings as well:

http://www.smj.org.sa/PDFFiles/Aug04/Delta20040158.pdf

http://www.nutritionj.com/content/3/1/9/comments

...kind of funny how he claims a "MD,PhD" in one paper and then a "MD,DSc" in another paper...especially when he doesn't provide a copy of his CV on his website and nowhere mentions his educational background...even more especially when you consider that it looks like he was busted by Italian police for practicing medicine without a license back in 1995 at which time he was using one of his "electric" therapy devices to treat AIDS patients:

http://translate.google.com/transla...09/16/dario-bellezza-non-ho-aids.html&act=url

 

[oncowiz]

rrtzrealmd, are you still trying to discredit this? Even after being sued by the company for libelous remarks and torturous interference?

The fact is that the military tested it on wounded soldiers at Walter Reed for a year before they decided to buy a dozen more for Naval hospitals across the country. They were pretty impressed with the pain relief that soldiers were getting. Also, they are conducting trials at the Mayo Clinic and the lead investigator, Dr. Loprinizi, has said that early results are very positive. Loprinizi has decided to conduct multiple trials he was so impressed. And the head of the Duffy Palliative Care at Johns Hopkins, Dr. Thomas Smith, has spoken very positively about it. He said that he's used TENS devices plenty in the past and that this is very different from any TENS device he's used. His last study found an 64% reduction in pain in CIPN patients. There have been plenty of studies that have found a 60-90% reduction in pain using Calmare with a response rate of about 80%.

Yes, the inventor is trying to cure everything with his inventions, from aids to cirrhosis to pain. And yes, the limited edition fan is ridiculous. But if the Mayo Clinic, VCU Massey Cancer Center, UW Paul Carbone Cancer Center and dozens of pain clinics across the country and multiple military bases use the Calmare therpay, I would have to say it's pretty intriguing. Apparently the medical director of palliative care at Johns Hopkins was pretty impressed with it.

 

[epidural man]

The fact is that the military tested it on wounded soldiers at Walter Reed for a year before they decided to buy a dozen more for Naval hospitals across the country.

Oh.

That explains why we have one sitting in the corner.

 

[lobelsteve]

rrtzrealmd, are you still trying to discredit this? Even after being sued by the company for libelous remarks and torturous interference?

The fact is that the military tested it on wounded soldiers at Walter Reed for a year before they decided to buy a dozen more for Naval hospitals across the country. They were pretty impressed with the pain relief that soldiers were getting. Also, they are conducting trials at the Mayo Clinic and the lead investigator, Dr. Loprinizi, has said that early results are very positive. Loprinizi has decided to conduct multiple trials he was so impressed. And the head of the Duffy Palliative Care at Johns Hopkins, Dr. Thomas Smith, has spoken very positively about it. He said that he's used TENS devices plenty in the past and that this is very different from any TENS device he's used. His last study found an 64% reduction in pain in CIPN patients. There have been plenty of studies that have found a 60-90% reduction in pain using Calmare with a response rate of about 80%.

Yes, the inventor is trying to cure everything with his inventions, from aids to cirrhosis to pain. And yes, the limited edition fan is ridiculous. But if the Mayo Clinic, VCU Massey Cancer Center, UW Paul Carbone Cancer Center and dozens of pain clinics across the country and multiple military bases use the Calmare therpay, I would have to say it's pretty intriguing. Apparently the medical director of palliative care at Johns Hopkins was pretty impressed with it.

Useless propaganda, no data.

 

[oncowiz]

Steven, I can understand why you might be skeptical - your practice is built upon invasive techniques: SCS, joint injections, nerve blocks, epidurals, etc. Any non-invasive technique would be a threat to places such as the spine center. Same for you, epidural man. Anyone who specializes in invasive techniques is going to be dismissive of Calmare therapy.

You should contact Dr. Thomas Smith (medical director of palliative care at Johns Hopkins) if you have any questions about his studies. Here's his study which was published in the Journal of Pain and Symptom Management:
http://calmarett.com/media/pdf/JPSM Pilot Trial Sept2010.pdf

His primary endpoint was a 20% reduction in pain and he achieved an average reduction of 64% (with 25% of patients getting 100% relief). Or you can contact Dr. Charles Loprinizi at the Mayo Clinic. He currently has multiple studies of Calmare therapy to treat both shingles and CIPN. There's plenty of data about efficacy.

 

[epidural man]

Steven, I can understand why you might be skeptical - your practice is built upon invasive techniques: SCS, joint injections, nerve blocks, epidurals, etc. Any non-invasive technique would be a threat to places such as the spine center. Same for you, epidural man. Anyone who specializes in invasive techniques is going to be dismissive of Calmare therapy.

That's ridiculous and not even true. I am sure Steve would say the same thing - most pain guys will use anything that helps if there is data to support it (although some won't if they can't get paid for it, that's just the way it is unfortunately).

And what made you think I was skeptical? I said I hope it works. (By the way I am - any pain studies that claim 80% to COMPLETE relief is a huge red flag.)

And that study you posted was interesting but let me ask you something oncowiz - what do you think, in medicine, is the best way to prove efficacy of an intervention? (Here is a hint, a small trial in 16 patients with no control or placebo is NOT the answer. Also, quoting big names that use the therapy is also not proof of efficacy)

If the therapy works, science will prevail. And I do understand that good and clean data is VERY difficult to come by on most things. The pain world is overrun with bias-ridden trials - not because we can't conduct good research, it's because it's so VERY DIFFICULT to do - to create a clean trial that is rid of bias.

Finally, I take exception that the company seems to claim that no harm can be done. If a therapy is powerful enough to make physiologic and biological change for the good, it sure is hell is powerful enough to make changes for the bad. Anything that claims no side effects or badness also claims they are useless.

 

[epidural man]

Steven, I can understand why you might be skeptical - your practice is built upon invasive techniques: SCS, joint injections, nerve blocks, epidurals, etc. Any non-invasive technique would be a threat to places such as the spine center. Same for you, epidural man. Anyone who specializes in invasive techniques is going to be dismissive of Calmare therapy.

You should contact Dr. Thomas Smith (medical director of palliative care at Johns Hopkins) if you have any questions about his studies. Here's his study which was published in the Journal of Pain and Symptom Management:
http://calmarett.com/media/pdf/JPSM Pilot Trial Sept2010.pdf

His primary endpoint was a 20% reduction in pain and he achieved an average reduction of 64% (with 25% of patients getting 100% relief). Or you can contact Dr. Charles Loprinizi at the Mayo Clinic. He currently has multiple studies of Calmare therapy to treat both shingles and CIPN. There's plenty of data about efficacy.

I do like that the funding source (which may have come from the makers of the product - it's hard to tell by the description) underwriters didn't have input into the writing of the manuscript.

I tell industry reps all the time how ******ed they are that they insist on being involved in the preparation of the manuscripts on the funded research. It speaks VOLUMES to the trust of their product or technique. It also speaks VOLUMES if they have trust in their product enough to say "we will give you the money, you just do the study and write the results." It's rare that someone does that though. Stupid stupid industry.....

 

[PMR 4 MSK]

That's ridiculous and not even true. I am sure Steve would say the same thing - most pain guys will use anything that helps if there is data to support it (although some won't if they can't get paid for it, that's just the way it is unfortunately).

And what made you think I was skeptical? I said I hope it works. (By the way I am - any pain studies that claim 80% to COMPLETE relief is a huge red flag.)

And that study you posted was interesting but let me ask you something oncowiz - what do you think, in medicine, is the best way to prove efficacy of an intervention? (Here is a hint, a small trial in 16 patients with no control or placebo is NOT the answer. Also, quoting big names that use the therapy is also not proof of efficacy)

If the therapy works, science will prevail. And I do understand that good and clean data is VERY difficult to come by on most things. The pain world is overrun with bias-ridden trials - not because we can't conduct good research, it's because it's so VERY DIFFICULT to do - to create a clean trial that is rid of bias.

Finally, I take exception that the company seems to claim that no harm can be done. If a therapy is powerful enough to make physiologic and biological change for the good, it sure is hell is powerful enough to make changes for the bad. Anything that claims no side effects or badness also claims they are useless.

 

[oncowiz]

"And what made you think I was skeptical? I said I hope it works. (By the way I am - any pain studies that claim 80% to COMPLETE relief is a huge red flag.)"

You're right, any device that claimed 100% efficacy and response rate, I would be skeptical too. The inventor claims to have a 90%+ success rate but no one else does. Most users claim to have about a 70-80% response rate with an average pain reduction of about 60-80%. But many people have had lasting pain relief which is something that you usually don't get with a TENS device.

The only adverse event that I have read or heard about was one girl who had lower-body RSD which went full-body after treatment and she had to be hospitalized for 10 days. Besides that, most people either get relief or they don't. I've read and heard about people getting relief for CIPN, RSD, CRPS, phantom limb, carpal tunnel, etc.

 

[lobelsteve]

"And what made you think I was skeptical? I said I hope it works. (By the way I am - any pain studies that claim 80% to COMPLETE relief is a huge red flag.)"

You're right, any device that claimed 100% efficacy and response rate, I would be skeptical too. The inventor claims to have a 90%+ success rate but no one else does. Most users claim to have about a 70-80% response rate with an average pain reduction of about 60-80%. But many people have had lasting pain relief which is something that you usually don't get with a TENS device.

The only adverse event that I have read or heard about was one girl who had lower-body RSD which went full-body after treatment and she had to be hospitalized for 10 days. Besides that, most people either get relief or they don't. I've read and heard about people getting relief for CIPN, RSD, CRPS, phantom limb, carpal tunnel, etc.

WIth only a few posts you attack my specialty. Where have you read about people getting relief for these things? How about you back up and identify your practice setting, your credentials, and why you are so in awe of this new and unproven device? Do you have any disclosures?

 

[lurkingrue]

rrtzrealmd, are you still trying to discredit this? Even after being sued by the company for libelous remarks and torturous interference?

So, wait -- putting aside the validity of the nearly miraculous and expansive claims made by the proponents of this device... you're ALSO denying the truth of rrtzrealmd's statements?

That *isn't* the inventors website? Those aren't his writings? He wasn't busted in Italy?

Really? That's what you're saying?

Just for the record...

Oh, and any f'**** lying charlatan who has the time and inclination can sue for almost anything, especially in this country. I'm particularly interested in hearing more about the inventor's previous dealings with the legal system, though...

 

[oncowiz]

"That *isn't* the inventors website? Those aren't his writings? He wasn't busted in Italy?"

That is and I already commented on that. My exact response was "Yes, the inventor is trying to cure everything with his inventions, from aids to cirrhosis to pain. And yes, the limited edition fan is ridiculous. But if the Mayo Clinic, VCU Massey Cancer Center, UW Paul Carbone Cancer Center and dozens of pain clinics across the country and multiple military bases use the Calmare therpay, I would have to say it's pretty intriguing."

In regards to the inventors legal dispute from almost 20 years ago, it was dismissed and the inventor went on to partner with Tor Vergata University in Rome, which incorporated his device and teachings in their medical school. The device later received the European CE mark as well as FDA clearance.

@Steve, I just read where your fellow spine specialists in Dallas are now using Calmare therapy. They also do epidurals, SCS, nerve blocks, etc as well as Calmare therapy.
www.spinedallas.com

 

[epidural man]

"That *isn't* the inventors website? Those aren't his writings? He wasn't busted in Italy?"

That is and I already commented on that. My exact response was "Yes, the inventor is trying to cure everything with his inventions, from aids to cirrhosis to pain. And yes, the limited edition fan is ridiculous. But if the Mayo Clinic, VCU Massey Cancer Center, UW Paul Carbone Cancer Center and dozens of pain clinics across the country and multiple military bases use the Calmare therpay, I would have to say it's pretty intriguing."

In regards to the inventors legal dispute from almost 20 years ago, it was dismissed and the inventor went on to partner with Tor Vergata University in Rome, which incorporated his device and teachings in their medical school. The device later received the European CE mark as well as FDA clearance.

@Steve, I just read where your fellow spine specialists in Dallas are now using Calmare therapy. They also do epidurals, SCS, nerve blocks, etc as well as Calmare therapy.
www.spinedallas.com

Thanks for answering some of the questions. We like engaging conversation, so we welcome enlightened minds.

I was wondering if you could answer Steve's question's though.

"Where have you read about people getting relief for these things? How about you back up and identify your practice setting, your credentials, and why you are so in awe of this new and unproven device? Do you have any disclosures?"

Also, i like my question as well. Perhaps you could answer this.

"what do you think, in medicine, is the best way to prove efficacy of an intervention? "