This week a new experimental treatment that targets the nerve bundles can potentially help patients with neck, upper arm and chest pain.
My guest Shaili Jain MD, Stanford psychiatrist and author of the remarkable 2019 book, The Unspeakable Mind: Stories of Trauma and Healing from the Frontlines of PTSD Science is in the unusual position of being both a leading-edge researcher and a clinician on the front lines. Her role as Medical Director for Integrated Care at the VA Palo Alto Healthcare System gives her a unique vantage point, inasmuch as her that VA hospital is a node within the Veteran’s Administration that concentrates on PTSD research and treatment.
In the interview, we discuss an experimental treatment approach I had just learned about, Stellate Ganglion Block (SGB). This technique which is in human trials is only offered at 12 VA centers. I learned about it on the very day of our interview where it was profiled on the popular, long-running U.S television magazine show 60 Minutes. I’m realizing that the technique needs a bit more explanation than we gave it in the interview. It involves injecting an anesthetic into the patient’s neck at a point near the spine where a nerve complex (the Stellate Ganglion) can be accessed. An injection of anesthetic into this nerve bundle can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm. In the 60 Minutes segment, the impact on several veterans they interviewed before and after the process was very dramatic. Within 5 to 15 minutes, the mood of these veterans visibly shifted from tense, pained, and hyper vigilant to relaxed, smiling, and optimistic. While it looked quite miraculous, again the show did caution that this treatment is still in the experimental phase and is only being offered in 12 VA facilities. They also stipulated that it is NOT a cure and that the relief may only last for a few months to a year. However, another important finding is that, for at least some veterans, it makes them more willing to follow-up with talk therapy.
To her credit, Dr. Jain does discuss the SGB therapy in her book. However, that discussion is in her chapter warning about the “allure of magic bullets” for treating PTSD. I think to some degree her caution was in response to earlier overly-enthusiastic reports proclaiming SGB as a cure. Something Dr. Jain reveals in her book that I didn’t delve into during our interview is her own history of trauma, a kind of generational trauma going back to the partitioning of India and Pakistan in 1947. She writes that in the ensuing upheaval up to 14 million people were forced to leave their ancestral homelands. Her father was 10 years old when he was orphaned and forced to leave Pakistan and live in India. Twenty years later he would move to England where today’s guest was born and raised. Even though she personally had not lived through the partition, she notes that her father seemed permanently scarred by it. She also reports that her own brown skin and foreign name made her acutely aware of being a second-class citizen in England. These events ultimately helped to shape her career to one of caring for those suffering from trauma.
You won’t find a more authoritative book on PTSD than Dr. Shaili Jain’s The Unspeakable Mind: Stories of Trauma and Healing from the Frontlines of PTSD Science.
Source: Shrink Rap Radio
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