Treat our returning warriors with a shot.
That’s the logic behind a new treatment for post-traumatic stress symptoms – and at least one clinician is reporting substantial early success.
This isn’t an ordinary flu shot, though. The injection required applies an anesthetic to “numb” a conflux of nerves inside your spine, close to the 7th vertebrae. Basically, it requires a horse needle to penetrate an inch and a half of tissue and inject the anesthetic directly into your spine.
The therapy itself isn’t new. It’s been used in pain management circles since the 1920s, and it’s widely used to treat menopausal symptoms among women. But one scientist, Dr. Eugene Lipov, an anesthesiologist practicing in the Chicago area, has modified the technique and is applying it to help individuals suffering from severe PTSD to control their symptoms.
Why does it work? Well, even Dr. Lipov isn’t entirely sure – which is part of why he’s been having trouble receiving funding to expand research and trials. But the theory is this: Traumatic experiences, such as combat, near-death experiences, rapes and the like, are associated with the manufacture of a hormone called Nerve Growth Factor. This causes the runaway development of nerves – specifically in a region of the spine called the Stellate Ganglion.
Historically, scientists have thought that they could control sympathetic symptoms of certain disorders by numbing the nerves in the Stellate Ganglion. For example, scientists have reported some success in helping breast cancer patients control night sweat symptoms, mitigate “hot flashes” in menopausal sufferers, and control profuse sweating of the hands.
Lipov was familiar with the technique in treating sympathetic nervous symptomology in these ailments, and hypothesized that the same logic might be effective in controlling certain symptoms of PTSD.
Is It Safe?
Some military people have viewed the technique with some trepidation. After all, memories die hard, and yes, the government did deliberately infect a number of servicemen with syphilis years ago.
This does not appear to be one of those cases. The treatment has a decades-long track record, and is generally considered safe. Side effects (other than the obvious pain and soreness you would expect when sticking a needle 1 ½ inches into your spine) are extremely rare. Doctors warn against the procedure if you are taking a blood-thinning agent, but that’s true of any invasive procedure. But long-term negative effects in previous applications of the treatment were on the order of 1 in 100,000.
More common side effects include difficulty swallowing and “a lump in the throat.”
Does it work?
It’s too soon to say for sure. An early study, published this year in the American Journal of Psychiatry, suggests that four PTSD patients out of nine reported an immediate and substantial improvement in PTSD symptoms. The problem: There were only nine patients in the study.
Naturally, it will take money to expand the study to a more meaningful sample of PTSD patients. But the government so far isn’t playing ball, according to wired reporter Katie Drummond, who has been following the story for some years already.
The application to PTSD is novel – but did have a full peer-review in the February 2012 issue of Military Medicine, a professional journal by and for the military surgical and medical community.
The study’s authors broadly confirmed earlier findings by Lipov and others, and reported the treatments appeared to be effective at helping mitigate two of the three major symptoms of PTSD – isolation and hyperarousal. There was no real improvement in “re-experiencing,” however. But the study only involved eight patients. There were almost as many doctors (seven) co-authoring the study… and one of them was Lipov.
While it seems counterintuitive at first blush, to treat a psychological ailment with an injection, most of the therapies currently in use aren’t exactly working out great. Other medications – antidepressants, anti-anxiety medications, and the like, can take months to become effective. And cognitive/behavioral therapies – talking it out on a couch – can take many months, with the therapist racking up billable hours all along the way. Even then, existing treatments for PTSD aren’t knocking the ball out of the park.
Cognitive therapy costs thousands of dollars per veteran over time – as do conventional drug therapies. In contrast, a stellate ganglion block treatment takes 10 minutes and costs about a thousand dollars.
Which is one reason why we expect the treatments’ popularity to grow among doctors.
But so far – and taken with the appropriate large grains of salt that such small samples demand – the treatment appears at least occasionally effective, and provides immediate symptom relief – within hours, claim the Military Medicine studies.
Early indications are that the treatment is even effective with “hard cases.” That is, treatment-resistant PTSD cases that have not been responsive to cognitive/behavioral therapy and pharmaceutical treatments.But you didn’t expect the easy cases to line up around the block to receive a horse needle in the back, did you?
President Barack Obama signed an executive order on August 31st directing a number of federal agencies to expand access to mental health care and services for servicemembers, their families and veterans. The measure comes amidst an epidemic of suicides among military members — amounting to as much as one per day.
Specifically, the executive order contained the following provisions:
- The Department of Veterans Affairs was directed to increase their veteran crisis hotline capacity by 50 percent.
- The VA was also directed to ensure that all veterans reporting themselves to be in crisis “connect with” a trained mental health professional within 24 hours or less.
- The VA was directed to work with the Defense Department to develop and implement a 12-month suicide prevention campaign (apparently they have to be told to do this).
- In areas where the VA has trouble recruiting qualified professionals, the President has directed them to form “pilot sites,” which will contract with local professionals to provide needed services.
- The VA is directed to hire 800 “peer-to-peer” support counselors, and as many as 1,600 new mental health care workers.
The President announced the executive order during a visit to Fort Bliss, Texas.
One former Army psychiatrist, however, says the order doesn’t go far enough. Writing for Time Magazine, COL Elspeth Cameron Ritchie argues that the Veterans Administration is already trying to hire 1,600 additional mental health care professionals, even without the executive order.
COL Ritchie has published extensively on mental health care issues concerning veterans and survivors of traumatic experiences. She collaborated with a number of colleagues to make additional recommendations for the President. Among them:
- Educate civilian mental health workers on how to work with veterans.
- Educate police and corrections officers on best practices in working with veterans.
- Train more college counselors.
- Bring more anti-PTSD medications to market, or expand their use.
- Re-look at security clearance questionnaires that force servicemembers to reveal mental health treatment, potentially discouraging some servicemembers from seeking treatment.
COL Ritchie also wrote “we need to re-look at gun laws, and ensure that gun safety is emphasized. This is the ‘third rail’ of suicide prevention, and I fear that no Presidential candidate will discuss this.”
What do you think of COL Ritchie’s implication that military members and veterans either aren’t trained on the safe handling of firearms, or that their access to firearms must be restricted?
Do you think this and her other suggestions would make a difference?
(Photo credit: MSNBC)
Auditions Open Through 8/31
If you have served in the Middle East, can carry a tune and live in the Delaware Valley area, you may be what producer Steve Holtzman is looking for.
Steve Holtzman is a seasoned reality tv producer, and Lou Faiola, of the Cherry Hill School of Rock, are collaborating on a new web-based reality show that will feature twelve musically gifted veterans of Operation Enduring Freedom or Operation Iraqi Freedom. The dozen talented men or women will form three rock bands and perform a Veterans Day concert.
Proceeds from all sponsorships, donations and ticket sales will benefit a non-profit organization called Give an Hour, based in Bethesda, MD. Give an Hour offers free mental health services to veterans of the wars in Iraq and Afghanistan and their families.
According to an article on Westminster Patch, Holtzman was inspired to develop the show in part by his daughter’s transformation after attending the Cherry Hill School of Rock. He says his twelve-year-old has blossomed from a shy adolescent to a rocking lead singer in the Cherry Hill house band. And he doesn’t think tweens are the only people who can benefit from a musical experience. Holtzman believes the power of music can help make a positive impact on military vets suffering from post-traumatic stress disorder.
A review of the National Center for Post Traumatic Stress Disorder reveals that between 11-20% of Iraq and Afghanistan war veterans suffer from PTSD. These “invisible wounds” can have a profound impact on veterans’ adjustment to civilian life as well as to their families and loved ones.
Although no one will be kicked off any island or booted from any kitchen on this program, there will be plenty of excitement and drama in the 10-episode series. Viewers will follow the bands as from the first time they meet until the season finale: a benefit concert at World Café Live on Veterans’ Day. Part of their journey will include surprise challenges, cameo appearances and advice from celebrity musicians, and guidance from professional stylists and sound engineers. A prize package awaits the winning band, but every musician will be a part of something special: knowing they have helped those who served.
The first episode in the series airs Sept. 13 on the show’s website. The season finale will be a benefit concert at World Cafe Live on Veterans’ Day. If you think you have what it takes to compete on the show, or want to find out how you can help make a difference in a veterans’ life, check out the Bands of Brothers website.
Emotional distress is a leading factor in suicides among military members, concluded a crack team of researchers without apparent irony. Demonstrating an uncanny grasp of the obvious, the researchers from the University of Utah’s National Center for Veterans Studies, who had interviewed some 72 military members at Fort Carson, Colorado why they attempted to commit suicide stated that theirs was the first study to provide actual data that documents that suicides among military members was related to emotional distress, and a desire to end it.
The study has not yet been published, but the authors have already received their grant money from the taxpayer. Taxpayers have already committed at least $50 million to research and study of the problem of military suicides. That’s the size of the pot of money entrusted to Colonel Carl Castro.
The study comes on the heals of relevations that it takes veterans an average of 41 days just to get an appointment to see a VA health care professional. In some areas, including Tacoma, Washington, that waiting period lasts as long as 80 days, on average.
High Correlation with Divorces or Separations
Although the scintillating conclusions reached by the University of Utah’s researchers have somewhat, umm, truncated immediate utility, we do have data that ties suicide risk with recent separation or divorce. Suicide rates among this population of servicemembers reached 19 per 100,000 – a rate that is 24 percent higher than single troops. The suicide rate among young adults age 20 to 24 is 12.7 per 100,000, according to the National Institute for Mental Health. So it does appear that Houston, we do have a problem, with military members at higher risk than the population of young adults at large.
IF YOU NEED HELP…Call this toll-free number, available 24 hours a day, every day: 1-800-273-TALK (8255). You will reach the National Suicide Prevention Lifeline, a service available to anyone. You may call for yourself or for someone you care about. All calls are confidential.
Veterans recovering from Post-Traumatic Stress Disorder (PTSD) cannot expect to heal overnight. It takes time and strength through a gradual, day-to-day process. Aside from standard counseling and treatment, there are other steps veterans can take to help themselves return to shape.
1. Count on fellow veterans. It might seem obvious to some, but next-to-impossible to others, but reaching out to other men and women who have experienced PTSD from their time in service can help. Sometimes pride or embarrassment can stand in the way of asking for help, but your brothers and sisters in arms know exactly what you are feeling and can be the best resource you have. Having an extended community of PTSD survivors around you can give you a secure environment for getting through your toughest days.
2. Continue your education with your VA benefits. Enrolling in a degree or certificate program can keep your mind occupied on something other than your past experiences and make you feel productive. Veterans who have successfully coped with PTSD have found that working through an educational challenge was beneficial to their recovery. The VA provides several programs to veterans to help with their education, including the Post-9/11 GI Bill, the Montgomery GI Bill and the Reserve Education Assistance Program (REAP).
3. Volunteer or Return to Work. Volunteering your time with a local organization, serving other veterans, youth, or elderly people in your community can give you a sense of purpose. Focusing on tasks at work and feeling a sense of achievement can also keep your mind occupied with positive thoughts.
4. Exercise to help your body and mind. Exercising has been shown to benefit people mentally as well as physically. Aside from increasing strength and releasing physical tension, exercise can provide relaxation, improve self-esteem and generate feelings of control over one’s life.
5. Talk, talk, talk. PTSD can be one of the loneliest experiences in your life. Know that you are not alone and open up to those in your social network. Isolating yourself will only make you feel worse. Spend time talking with friends, family, work colleagues and others around you. You don’t have to talk about your PTSD or painful memories. Talk about any topic, small or large, to stay connected with those around you.
Overcoming PTSD is a challenge to be sure. But you are a warrior, trained to be strong and face challenges head-on. This one is no different. Reach out to family, friends, and fellow veterans to get through each day, and find something bigger than yourself to focus on. It will get better.