I am a retired (21 ½ years) Infantry First Sergeant (E-8) who served in the Gulf War, Haiti, Iraq and Afghanistan. I am an avid writer, fisherman and outdoor enthusiast. I call Kuna, Idaho home and hope to one day write professionally.
It is interesting that a shot may be the answer to turning off intense emotions. Not sure I would want to test this new procedure out. What do you think?
By Gidget Fuentes - Staff
Posted : Monday Dec 26, 2011 11:41:48 EST
Top of Form
SAN DIEGO — After seeing promising
results with an innovative treatment for post-traumatic stress disorder, a
group of Navy doctors in San Diego hopes a new study will show a shot in the
neck that quiets nerves could bring quick, lasting relief to suffering combat
In a pilot study at Naval Medical
Center San Diego, 42 active-duty service members will get injections to block
or turn off nerves from transmitting triggers that can cause anxiety,
hyperarousal or other symptoms of PTSD. Such nerve blocks, much like basic pain
management treatments first done in 1925, typically bring relief in a few days,
if not several hours, and in the weeks or months after the procedure.
The study, funded by the Navy Bureau
of Medicine and Surgery, uses a stellate ganglion block, or SGB. The treatment
involves injecting an anesthetic into the stellate ganglion — a bundle of
nerves in the neck — which blocks pain signals in the sympathetic nerve system
from reaching the brain.
So far, more than 20 patients
diagnosed with PTSD have begun the voluntary three-month program, which
involves two or three injections of either the real treatment or a placebo,
said Capt. Anita Hickey, an anesthesiologist and director of Pain Research and
Integrative Medicine at the medical center.
The procedure lasts a half-hour for
patients, who in most cases are sedated or receive a topical anesthetic in the
neck. An X-ray and, in the case of the San Diego study, an ultrasound machine
guide the proper placement of the needle and direct the anesthetic to the
targeted spot, Hickey said. The treatment includes checkups at one week, one
month and three months after the initial shot, with possible subsequent
injections of either the placebo or the anesthetic.
Research shows an SGB injection
“does have an effect on the sympathetic nervous system in the brain,” said
Hickey, who has used nerve blocks in pain management. She described the
treatment as “rebooting a computer,” with most patients seeing reduced PTSD
The study team hopes to present its
findings in May at an American Psychiatric Association meeting and ultimately
get more funding for continuing research and larger clinical studies. An
article Hickey co-wrote about the effects of SGB treatment on eight combat vets
will be in the February issue of Military Medicine, the Journal of the
Association of Military Surgeons of the United States.
The Navy’s study takes a page from
Chicago anesthesiologist Dr. Eugene Lipov, who in 2008 first used the treatment
for PTSD sufferers. Lipov, who so far has used the treatment on 30 combat vets,
unsuccessfully tried four times to get Defense Department funding for a larger
clinical trial, but he now provides the $1,000 treatment to patients partly
funded through donations.
Lipov, who with Hickey co-wrote an
earlier paper about the stellate ganglion block, said the treatment eases
symptoms and can reduce emotional reactions to trauma without erasing the
The treatment shows promising
results, a Navy psychiatrist involved in the trial said.
“We do see some benefits at one week.
People are more calm, are having fewer nightmares, are able to do more things,”
said Dr. Robert McLay, Naval Medical Center San Diego’s mental health research
director and psychiatrist who works with troops with PTSD.
McLay, an admitted skeptic, is excited
about the treatment. “I think it potentially could really change the thinking
in some respects with responding to PTSD,” he said.
Popular treatments range from
medication and counseling to virtual-reality exposure and even alternative
therapies such as yoga and art. But as the Iraq and Afghanistan wars wind down,
with as many as one-quarter to one-third of combat vets suffering from PTSD,
officials expect to see larger caseloads.
However, defense health officials
told a Bethesda, Md., conference this month that fewer than half of PTSD
patients are helped by medications and psychotherapy. Lipov said he has seen 80
percent success among his veteran patients so far, but he acknowledged further
study will refine the treatment and help doctors better learn which patients
and symptoms are helped the most.
Medical experts say the complexity
of PTSD, how it affects different patients, and lack of understanding about how
the brain works all add to the difficulty of treating — if not curing — the
disorder. Combat veterans can suffer nightmares, headaches, depression, anxiety
PTSD patients “by their very nature
are very jumpy, very hesitant to jump into things,” McLay said. “We’ve actually
been getting more volunteers for a shot in the neck ... than coming in and
having to meet me twice a week to talk about their trauma.”
Dr. Maryam Navaie, a San Diego
research consultant who’s worked with Hickey and Lipov, said SGB treatment
requires a shorter commitment, so it’s easier for the vets. “Compliance is 100 percent,”
said Navaie, compared to 30 percent to 40 percent for those who are prescribed
That ease and fast relief appealed
to Aviation Structural Mechanic 1st Class Christopher Carlson, who retired in
2010 after multiple deployments in a 20-year career that included at-sea tours.
Carlson said he subsequently was diagnosed with PTSD after getting worsening
bouts of cold sweats, disrupted sleep, anxiety and severe nightmares “that
seemed almost real.”
He was prescribed medications, “but
really nothing seemed to be working,” he said, and his struggles sidetracked
him from getting good employment after he retired in Norfolk, Va., and moved to
Chicago. He drank more, was depressed and got more forgetful; he and his wife,
who have four children, divorced.
On a fluke, someone told him about
Lipov’s treatment. Desperate for relief, he volunteered.
“It seemed like it was a miracle
cure,” he said. “It changed my life.”
After his initial improvement seemed
to wane a few months after the first injection, Carlson got a second treatment
and noticed “night and day” changes.
“My mind is a lot clearer, and I’m
sleeping better,” he said Dec. 14. “My emotions are a lot better.”