A Life Changing Treatment For PTSD
By Dr. Brian Shiple
Post traumatic stress disorder (PTSD) is a condition that is common in people who have suffered physical or emotional trauma. Symptoms include agitation, anxiety, depression, a heightened state of awareness, and nightmares or unwanted memories of the trauma. The fight or flight mechanism in these patients is always on and overactive. Many who suffer from PTSD find it difficult to relax, be themselves, concentrate on work, or enjoy life.
Although recent wars that our country’s military has been involved in have brought this epidemic to the public’s attention, you do not have to be a war veteran to have PTSD. While the typical patient is a combat veteran, the most common cause of PTSD in females is sexual assault. Typical options offered for management of this condition include counseling and psychiatric medications that have significant side effects. Unfortunately, these treatment options are not usually successful in this patient population.
However, there is a new, effective treatment being used with increasing frequency in the military that has the ability to reduce the symptoms of PTSD much more effectively than the current standard of care. In many patients it has not only reduced symptoms, but has also cured them with only one to two treatments. This treatment is called a stellate ganglion block (SGB). The SGB has been used safely for many years in military veterans with phantom limb pain. A very astute pain medicine doctor noticed when he gave his patients with phantom limb pain these injections, they often reported improvement in their PTSD symptoms, as well. A former military doctor, Sean Mulvaney, MD, came across the report documenting this phenomenon and decided to try it in his patients suffering from PTSD. He found that not only did it work, but also completely cured many of his patients of their symptoms. He began his own research on this treatment and today the army is conducting a large, multicenter, randomized controlled trial to prove that SGB for PTSD should be a standard treatment for this epidemic. There is a significant body of research that supports this effective treatment currently, but more research is needed before the insurance companies will cover this life saving treatment. For now, it is considered experimental and is not covered by insurance.
Patients are first evaluated to determine the level of severity using the Post Traumatic Check List DSM-5 (PCL-5). The actual injection takes just five minutes and involves a very accurately placed injection into the longus coli muscle in the neck performed under ultrasound guidance. By flooding this fascial plane with a long acting anesthetic, the stellate ganglion is reset, in a sense, and the constant fight or flight response is finally turned off. The patient is observed for effect for fifteen minutes following the treatment. Many feel a sense of calm spread over them as the injection is being performed. Horner’s Syndrome symptoms, including eyelid drooping, eye redness, and pupil dilation, are signs of a successful SGB. These side effects wear off within a few hours and patients may begin to experience reduced anxiety and agitation as soon as the day of treatment. A driver is required for this procedure. Overall effectiveness is determined and the patient is re-evaluated four weeks after treatment.
Eight years ago one of my patients came to me for a regenerative, musculoskeletal treatment prior to her wedding because she wanted to be able to walk down the aisle without a brace. She had been responding well to these treatments, and suddenly stopped showing up for them. When she eventually returned to my office we discussed the reasoning for this and it was discovered that she was sexually assaulted as a teenager. After recently coming across a stray puppy and trying to force feed it some warm milk for nourishment, memories of her assault were triggered and she began having panic attacks and flashbacks. Watching TV and hearing the word “rape” continued to trigger her symptoms and she would have to miss a week of work and life in general in order to completely recover from one of these episodes. We decided to proceed with an SGB to see if this could help her symptoms. After the block was performed she felt an overall sense of well-being. As we were observing her for effectiveness she started whispering and then saying the word “rape” out loud. She explained that even thinking of this word would cause her heart to race and anxiety to build. However, she now felt calm and at peace. She went on to walk down the aisle without a brace and with her PTSD behind her.
If you are suffering from symptoms of PTSD or know someone who does, we may be able to help you change your life, wean off medication, and get you back to feeling like yourself again. We are offering one free SGB per month for veterans unable to afford treatment. Our hope is that we can get the word out so this epidemic may be better controlled and hopefully even ended with this life saving treatment. Call the office for a PTSD assessment today.
Credentials:
Dr. Brian Shiple is a highly accomplished sports medicine board certified physician. Dr. Shiple is one of the leading interventional regenerative medicine physicians on the east coast and uses platelet rich plasma and adult stem cells for the healing of musculoskeletal conditions. He has been practicing age management wellness and aesthetic medicine for over 8 years. He has been in practice for 23 years and is a highly sought after speaker, educator, and author.
