Saturday, July 24, 2010

Magic mushrooms & no magic bullet for patient communication


Johns Hopkins tells us that researchers are looking at illegal drugs to help people with OCD (obsessive-compulsive disorder), PTSD (post-traumatic stress disorder), anxiety and depression--anxiety being Cancer Bitch's major bugbear. MDMA aka Ecstacy, says Johns Hopkins health reports, also increases brain levels of oxytocin, which arouses feelings of trust and confidence that can be particularly helpful during psychotherapy. The idea is that a dose of the drug, taken before a talk therapy session, may help individuals with PTSD reduce their fear and anxiety long enough to discuss and process the events that traumatized them. Ketamine aka Special K, is an FDA-approved general anesthetic that is being studied as a fast-acting antidepressant. Ketamine binds to receptors in the brain and blocks the neurotransmitter glutamate that normally activates neurons, thus producing a calming effect.

I haven't tried any of the above, though in high school, the guys in Future Farmers of America were allegedly growing the mushrooms on their school farm. It was the '70s, after all.

You can participate in clinical trials of these drugs (or a placebo)if you meet the criteria. For example, New York University is administering one dose of psilocybin to anxious people with life threatening, advanced, or recurrent cancer. If you're in Baltimore, check a study out here.

University of Rochester is studying whether topical amitriptyline and ketamine cream are effective in treating neuropathy caused by chemo.

There are tons of clinical trials and they can save or at least improve lives, even your own. For example, in researchers in Downstate Illinois are studying how best to get breast cancer survivors to exercise. There's another one on whether flaxseed is helpful in combatting hot flashes. My favorite is one at Fancy Hospital on communication with patients. A major goal: •Determine patients' health communication needs during the first 6 months of care by interviewing patients with breast cancer (as well as their families, caregivers, and healthcare teams) and observing interactions between patients and oncologists throughout the trajectory of care from initial diagnosis through the initial treatment course.

This involves video and extensive interviews. What should also be done:

* HIRE ENOUGH ONCOLOGISTS & STAFF SO THAT THE WAIT TIME IS NOT TWO HOURS FOR CHEMO OR ONCOLOGY APPOINTMENTS.

* REQUIRE DOCTORS TO READ PATIENTS' CHARTS BEFORE ENTERING THE EXAMINATION ROOM.

* REQUIRE DOCTORS TO SIT DOWN DURING PATIENT APPOINTMENTS.

* TRAIN DOCTORS (STARTING WITH MEDICAL STUDENTS) WITH EXTENSIVE ROLE-PLAYING EXERCISES.

* INVITE JEROME GROOPMAN TO TALK TO ALL STAFF ABOUT COMMUNICATION WITH PATIENTS AND FOLLOW WITH SMALL MIXED (SEE POINT BELOW ABOUT MIXING STAFF) DISCUSSION GROUPS ON RELATING AND COMMUNICATING WITH PATIENTS.

* CONTINUE ATTEMPTS TO LOCATE/ENCOURAGE HUMANITY IN DOCTORS AND TO BREAK DOWN THE HOSPITAL HIERARCHY (BASED ON RANK, EDUCATION, CLASS AND MOST OF ALL RACE) BY HOLDING WRITING WORKSHOPS, BOOK AND OTHER DISCUSSION GROUPS, IMPROV & EXERCISE CLASSES AND OTHER ACTIVITIES THAT INCLUDE EVERYONE, FROM IMPORTANT & SELF-IMPORTANT DOCTORS TO CLERICAL STAFF.


* HIRE HOSPITAL CLOWNS TO EASE TENSION & BRAINSTORM WITH THEM ABOUT IDEAS TO EASE ANXIETY AND COMMUNICATION. IT'S HARD TO LISTEN WELL WHEN YOU'RE TENSE.



To search for clinical trials, go here.

No comments:

Post a Comment