Posts Tagged ‘Debra Bruno’

Hypnotherapy Can Aid Some With Surgery

December 12, 2019

The title of this post is identical to the title of an article by Debra Bruno in the Health & Science Section to the 12 November 2019 issue of the Washington Post. Some U.S. hospitals are offering hypnosis to patients to lessen preoperative anxiety, to manage postoperative pain, and even to substitute for general anesthesia for partial mastectomies in breast cancer. The article notes that hypnosis has been used of years to help people quit smoking, lose weight, get to sleep, and control stress.

Staff anesthesiologist Elizabeth Rebello of Houston MD Anderson Cancer Center uses hypnotherapy for segmental (partial) mastectomies and sentinel node biopsies, in which doctors identify and remove a lymph node in the underarm area as well as cancerous tumors in the breast.

Although there have been no published results yet of the hospital’s ongoing randomized control study comparing surgical patients who get either general anesthesia or hypnosis with local anesthesia, the feedback from the 60 hypnotized patients in the study has been positive. Before the surgery, patients have a 15 to 20 minute practice session with a hypnotherapist. During the breast surgery itself, the patients are awake and EEG monitoring of brain electric impulses show many patients responding to the hypnotherapy as if they were under sedation. When asked if whether they would undergo hypnotherapy again, the overwhelming response is “yes.”

The definition for hypnotherapy is “focused attention that allows a patient to enhance control over mind and body.” It can work for minor surgeries. It also could be an option for older patients who are more susceptible to delirium after general anesthesia.

Patients need to be able to expect that their pain can be controlled by a combination of local anesthesia and hypnosis. Anesthesiologists don’t want to compromise the procedure because the patient is suffering and in pain.

It is not surprising that hypnotherapy works with pain management. Pain perception, because it originates in the brain, can be different for every person. Hypnotherapy can alter how much pain a person feels. Stanford medical school offers patients classes in self-hypnosis to deal with a variety of medical issues, including pain, stress-related neurological problems, phobias, and side effects from medical treatments, such as nausea, vomiting, and cancer.

Dr. Elizabeth Rebello, an associate professor in anesthesiology at MD Anderson Cancer Center in Houston, notes that using hypnotherapy in place of sedating and pain medications in some breast cancer surgeries has resulted in less reliance on opioids for relief during and after the procedure. She says, “Hypnosedation will not completely replace general anesthesia, but in some cases when the standard of care is general anesthesia, hypnosedation might be a better plan. If this is the case we owe it to our patients to explore this option.”

Two Disturbing Articles About Cognitive Decline

April 22, 2018

There were two disturbing articles about cognitive decline in the Aging Issue in the Health & Science section of the 17 April 2018 issue of the Washington Post. To be fair, two were positive articles. One positive article was by Marlene Cimons titled “Many seniors don’t accept stereotypes about aging.” Becca Levy, a professor of Psychology at Yale did a study that found that older adults with positive beliefs about old age were less likely to develop dementia, including those who are genetically disposed. She writes that negative age stereotypes are communicated to children through many sources, ranging from stories to social media. Individuals of all ages can benefit from bolstering their positive images of aging.

Another positive article was by Debra Bruno titled “Even in their 80s, these seniors set a very active pace.” She lists the following eight lessons:
Have a purpose, a reason to get up in the morning. Healthy memory blog readers should recognize this as “ikigai.”
Celebrate and cultivate the social connections.
Do not be defined by your obstacles.
Money isn’t as important as you think.
Acknowledge that aging can be lonely.
Have a routine.
Location is important.
Death has no dominion

By far the worst article is by Kirk R. Daffner and is titled “How will I know when it’s time to retire?” This fellow is a neurologist and clinical director of an Alzheimer Center. His advice is to have a “Living Will for his Cognitive Skills” Basically he is conceding defeat and writing an article of surrender. I find it both disturbing and frightening that he is both a neurologist and clinical director of an Alzheimer center. He is woefully ignorant of relevant key research on the topic, and this ignorance does not bode well for patients at his center.

Another article, which is somewhat positive, but still disturbing, is by Lauren Neergaard and is titled, “Scientists study brains of “superagers’ to study their unusual memory. His definition of a superego is a useful brain in the body of someone 80 or older. Rogalski’s team has tested more than 1,000 people who thought they’d qualify, and only about 5% pass. Here is the test:listen to 15 unrelated words, and a half-hour later recall at least nine of them. Neergaard says, “That’s the norm for 50-year olds, but on average an 80-year old recalls five. Some superagers remember them all.

Now when HM was in graduate school, he would not have been able to recall the 5 words that Rogalski says is the norm for an 80 year old. To be sure, his superagers, are truly super, but the problem involves people who read this, do poorly, and conclude that they are in the process of cognitive decline. It is ridiculous to write something like this, and for an editor to publish it. It is a damaging statement. First of all, people should never self-test. And even if they did publish the test, the specific protocol for the test needs to be published (how the words are selected, the method of presentation, the study time, and what is done in the inter-test interval).

The following healthy memory blog posts need to be read: The Myth of Cognitive Decline and More on the Myth of Cognitive Decline (Use the healthymemory blog search block). Research has shown through simulations (which is the only way this issue can be practically studied), is that memory processes become slower as we age because those of us who are active learners acquire magnitudes of order more information across time. HM has a colleague in his nineties who appears to be slow and apologizes for “senior moments”. HM cautioned him never to apologize because his apparent slowness was due to the enormous amounts of information he has acquired over his active learning lifetime.

One of the superagers who will be 87 next month and who joined Rogalski’s study two years ago is interesting. His father developed Alzheimer’s in his 50s. He thinks his own stellar memory is bolstered by keeping busy. He bikes, and he plays tennis and water volleyball. He stays social through regular lunches and meetings wit a men’s group he co-founded. Rogalski’s research is interesting and he is finding anatomical information about the brain that is important.

The article also mentions the research that Claudia Kawas is doing at the University of California at Irvine. She studies the oldest old, people 90 and older. Some have Alzheimer’s. Some have maintained excellent memory, and some are in between. She’s found that about 40% of the oldest-old who show no symptoms of dementia during life nonetheless have full-fledged signs of Alzheimer’s disease in their brains at death, Kawas told the AAAS meeting. The common explanation for this finding is that these individuals had built up a cognitive reserve, presumably due to learning during their lifetimes. Rogalski has also found varying amounts of amyloid and tau, hallmark Alzheimer’s proteins in the brains of some superagers.

Rogalski asks, “Are there modifiable things we can think about today, in our lives to live long and live well.

HM is glad he asked. First of all, live a healthy lifestyle. Then focus on the primary organ, the brain, and how you use it. HM advises to have a growth mindset throughout one’s lifetime. That is to keep learning throughout one’s entire life. HM also has the conjecture, a strongly felt conjecture, that a specific type of processing is important. Nobel prize winning psychologist, Daniel Kahneman presented his two process model of cognition in his best selling book, “Thinking Fast and Slow.” System 1, called intuition, is our normal mode of processing. System 2 is called reasoning and corresponds to what we call thinking. Most learning has a heavy involvement of System 2 processing.

HM also thinks that meditation, in general, and the relaxation response, in particular, is beneficial to both personal and cognitive health. Enter “relaxation response” into the search of the healthy memory block to learn more. Meditation and mindfulness develop the ability to focus one’s attention, which is critically important to effective cognition.

© Douglas Griffith and healthymemory.wordpress.com, 2018. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.