The Power of Placebo

In a recent issue of the New Yorker, long-time staff writer Michael Specter explored the nature of the placebo effect in medicine, primarily by describing the work of Ted Kaptchuk, who directs Harvard University’s Program in Placebo Studies and the Therapeutic Encounter (PiPS). The program’s mission is “to examine the placebo response and the implications of medical ritual, the patient-provider relationship, cultural context, and the power of imagination and hope in the healing process. Through endeavors in the clinical, basic, and social sciences, bioethics, the history of science and philosophy, PiPS seeks to elucidate, quantify, optimize and reaffirm the humanistic and more intangible dimensions of health care.”

Kaptchuk, who studied Chinese medicine in Macau and practiced acupuncture for many years, is arguing for a shift in contemporary medicine away from high-tech and pure science to a greater emphasis on healing. Having recently received funding from the National Institutes of Health, he and his colleagues are undertaking neuroimaging and molecular studies to understand the biological underpinnings of the placebo response.

In one study, he and his group acknowledged that a problem in directly exploring the placebo effect in a clinical setting was the use of deception — not letting patients and providers know of they are receiving an active drug or not. So they designed a randomized study in which patients with irritable bowel syndrome were given pills they were told were “an inert substance, like sugar pills” or no treatment. After 21 days, patients given the placebo had significantly different changes on global improvement scores (5 versus 3.9, P=0.002) and symptom severity (P=0.03).

In another study, patients with asthma were randomized to treatment with an albuterol inhaler, a placebo inhaler, sham acupuncture, or no treatment. The albuterol group experienced 20% improvement in forced expiratory volume in one second (FEV₁) measured on spirometry, and the other three groups all improved by 7%. However, when patients were asked if they felt better, 50% on albuterol reported improvements, as did 45% of those using the placebo inhaler, and 46% of those who had sham acupuncture, compared with only 21% of those who had no treatment (P<0.001). The researchers concluded that, while objective measures such as FEV1 are important in asthma care, “other outcomes such as emergency room visits and quality-of-life metrics may be more clinically relevant to patients and physicians.”

Specter concludes his article with a personal anecdote. He had been experiencing chest pain and was worried, being an overstressed middle-aged man, so went to his doctor, who conducted a careful examination. The physician told him he was fine, but needed to relax — and the pain simply disappeared. This was an example of “exactly the type of ritual that, according to Kaptchuk, will have to play a critical role in the future of American health care.

So what do you think should be the role of placebo — if any — in tomorrow’s medicine?

Original article: The Power of Placebo http://bit.ly/t39hKo from @medpagetoday

Polar Express in Pictures!!

Thankful Thursday: White Noise & "Dates"

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. Please take this time to share with us what you're thankful for as well. If you have a blog expressing your thankfulness, please share the link! Without further ado, here's what we're thankful for:

Mandi's List:

I'm thankful for learning. Mckenna seems to be learning and growing every day and it's sooo incredible and fun to watch. She's now so smiley, chatty, and playful and I love it. I can't wait to watch how much she changes over the next few months.

I'm thankful for white noise. Mckenna loves white noise when she seems to sleep a lot better when it's on. We downloaded white noise tracks from iTunes and play them at night time and bed time...I don't see us getting rid of that method of sleep induction any time soon!

I'm thankful for the holiday season. My parents get back into town on Saturday for Christmas and new years and I cannot wait to see them again!! It's only been a month but that's felt far too long.

Ronnie's List:

I'm so thankful for a wife that pushes us to do things out of the ordinary. A couple of days ago we traveled up north to ride on the Polar Express (pictures will be posted tomorrow). Now, that's typically not something that I would choose to do, but I had a great time and look forward to going back for years to come!

...and on that note I'm thankful that Mandi encourages me to be social. Truth be told, I could stay at home and hang out with my family all day everyday, but Mandi takes it upon herself to set up "dates" with friends. I appreciate her taking the lead on it as it's generally something that I don't press, and I always have a good time with whatever she has set up!

I'm thankful that Mckenna is a fan of my Vest. It's pretty much a guarantee that as soon as my vest starts and Mckenna is in her swing, she'll be out for the count. You of course never quite know how babies will react, and I'm just thankful that she's not scared of it....yet :)

 

So, what are you thankful for today?

Sign Me Up!!!

Where do I sign-up? I think I'd be pretty good at THIS kind of hand-to-hand combat!!

Top Ten Tuesday: Why I Don't Like the Rain.

I think I finally discovered my kryptonite - Rain. Don't get me wrong, once in a while it's an okay thing, but generally speaking, I could do without it. Here the top 10 things that I don't like about the rain:

10.  Watering schedule. Whenever it rains like it did today I have to worry about the setting or altering the current watering schedule for my yard. Big deal? No, but it's still a nuisance.

9. Shoes. I guess I have to wear shoes when it rains but I'd much rather have dry feet than wet. The only problem with this is that I would much rather rock my sandals.

8. Blue skies. One of the reasons I love living in Arizona is that I can count on blue skies almost every single day of the year. When it rains, I'm stuck staring at a gray sky all day.

7. Sleep. I've never been one to take a nap, but when it's raining all day I suddenly have the urge to. It's tough to get going and get things done when you're yawning and feeling like you need to lay down for a while.

6. Lethargic. Not only do I feel like I need to take a nap, but every action I take feels 10 times lower than the same action that I took the day before. It's almost like I'm covered of molasses... including my brain.

5. Gym. Because of the previous 2 reasons I just stated, you could see how the rain messes with my gym time. Without Mandi calling me out yesterday, I'm not so sure I would've made it. I'm of course glad that I went, but it was tough.

4. Joints. As I'm sure is the case with many of you, my joints start to really ache when it rains. I'd say it's the worst in my ankles and knees, but the pin in my wrist doesn't feel that great either.

3. Jezzabel. Whenever it rains my sweet little dog turns into a scared little puppy. She's attached on our hip, which I really don't mind all that much, until she has to go to the bathroom.

2. Messy. Everything just seems to get a little more dirty or messy when it rains. Whether it's our clothes or the floors to our house, everything just seems to get a little dirtier.

1.  Circadian rhythms. I'm a big believer in circadian rhythms and there's no doubt that the rain throws mine for a loop. I've touched on some of the ways that rain affects me, but I just the best way to sum it up would be to say that it just makes me feel “off”.

Now I'm guessing that most of you out there probably like the rain. For the sake of this blog I of course lived it up a little in terms of stating all of the reasons I don't like the rain, and although I can name plenty of reasons that I like the rain, I still think this list would outnumber it.

So my question for you is: Do you like when it rains? Why or why not?

Learning through a Butt Dimple?

As you may or may not know, I'm a worrier. I'm pretty sure I've expressed that before, but if I haven't or you haven't read it, there you have it. I've outted myself :) Ronnie is the complete opposite when it comes to worry. I'll worry about just about anything. He could have his arm cut off and his worry would be about a 1 on a 1 to 10 scale. Whenever we have a potential issue, problem, dilemma, my mind wanders and I begin to worry about the what-ifs. I come up with all the possible what-ifs, and then begin to think of solutions and next steps for each of those possibilities. Ronnie finds this absolutely ridiculous. He is constantly telling me, "let's start to worry when we actually know what's going on." or "let's wait until we have an answer and then we can discuss all the options." And I always know he's right, but that doesn't stop a worrier from getting stuck in the worry-cycle when something arises.

However, this last month, I managed to break out of my typical pattern - and even while in new mom mode. Shortly after Mckenna was born, we noticed a little "dimple" on her bum - at the top of her crack. Many babies are born with a dimple (1 in 50), but hers was on the "bigger side of normal". And while they told us it was probably nothing and just a slightly bigger than normal dimple, each nurse took an extra peak at it while we were in the hospital...which can send a worrier like me into a tail-spin. At her first appointment with the pediatrician we asked about it. She told us that she too thought it was likely nothing, but that they would order an ultrasound to look and make sure all was ok with her spine/spinal cord. We were told that it would be correctable if it was something, but that it would be something on the spina bifida spectrum.

Typically something like this would make me a worried mess. But for some reason I felt ok about it. Maybe because if it was "something" it could be corrected with surgery, or maybe because I (gasp) am actually learning something from my steady-eddy husband. Regardless, I wasn't too worried.

Well wouldn't you know, Ronnie was right and not worrying until we had more info paid off and saved me a lot of mental anguish. We had her little dimple looked at last Friday, and all checked out fine - the dimple was nothing to worry about!

It's funny how God can grow you and teach you through experiences like this. Somehow He kept me at peace about the situation, and wouldn't you know, it was nothing. I learned that if I wait to worry, I can free up a lot of mental space!