Page 41 - February 2021
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 The Stella Center has tested the SGB on more than 320 patients to reach the initial 80 percent efficacy. Good success numbers to be sure, but also a small sample size.
Testimony, however, to the positive outcome of the block also comes from the center’s chief psychologist, Dr. Shauna Springer. Springer has spent 12 years studying the effects of post-traumat- ic stress on members of the military and first responders. She has spent 12 years helping people develop the insights they need to heal from trauma, primarily with therapeutic approaches.
But Dr. Springer has learned enough about it to discern that trau- ma is a biological injury that can be treated in large part through a biological approach. She has come to realize that the SGB might be especially effective for law enforcement, because the trauma they deal with piles up very differently than that of those who serve in the military.
“It’s the fact that they have to live in two worlds at the same time, the world where they have to enforce the law and deal with some of the greatest evils among men, and then come into one where fami- ly or a support system needs them to be responsive, nurturing and warm. It causes emotional whiplash,” Dr. Springer elaborates.
It also leads to an elevated and prolonged state of chronic threat response. Springer notes that her patients describe it as being in overdrive and not being able to throttle down.
She has seen this contribute to a sense of helplessness and hope- lessness and elevated suicide risk. Consequently, a lot of good men and women who dedicate their lives to service are made to feel that post-traumatic stress is a life sentence.
“What I know is that it’s not a life sentence based upon the in- novative approaches to treatment I am now aware of,” Dr. Springer reports.
The stellate ganglion block is not voodoo. There is no incantation required. It is science.
Dr. Lipov started researching its uses to treat various disorders, including complex regional pain syndrome, hot flashes, migraines, facial pain and upper extremity pain. Before long, he had read more than 3,000 articles and case studies about its usage and made the connection about how the stellate ganglion is connected to brain regions thought to be abnormally activated in PTSD.
Multiple studies that have examined brain imaging before and af- ter PTSD treatment provide evidence of this biological rationale for the effect of the SGB on PTSD. Dr. Lipov refers to one of his first test cases with a military veteran who was patrolling the streets of Bagh- dad and had to take out a 10-year-old suicide bomber coming after his squad. The child exploded into pieces, some of which hit him.
Dr. Lipov reports that the soldier’s PTSD became so bad that he tried to strangle his wife three times.
“I did one stellate on him, then another six months later,” he adds. “And he is still married to the same woman 13 years later.”
According to the science, the application of a local FDA-approved anesthetic to the stellate ganglion region leads to a reduction in nerve growth factor and a resulting decrease in sympathetic nerve sprouting and brain norepinephrine levels. These are the fight-or- flight nerves that incite the symptoms of post-traumatic stress and make it feel like a life sentence of misery.
“Norepinephrine is like adrenaline. So as long as norepineph- rine levels are increased in the brain, you’re going to be in a PTSD state,” Dr. Lipov explains. “The block reduces the nerve growth fac- tor (NGF) level. It leads to pruning, so those nerve fibers that have grown inside the brain have gone away. Norepinephrine goes down, and people feel much more calm and relaxed almost immediately. In some cases, it has worked in 10 minutes.”
Dr. Lipov often hears the question you’re probably thinking right about now. No, the SGB does not turn you into a zombie or a slug.
“Turns out, this actually increases your reaction time,” he details. “If you think about it, you’re distracted if you have PTSD. You see something that catches your eye, and you take out your gun and shoot because you just freaked out. If you’re going to discharge your weapon, you have to have control of that weapon. And this gives you a lot more control. Because if you think about it, you are calm and collected. You have laser vision. You are not distracted by garbage.”
Dr. Lipov, who has had the SGB himself, also notes that 85 percent of patients who have done the SGB have experienced an improve-
How the stellate ganglion block is administered
ment in sexual dysfunction. But there is some additional work to be done after the block, albeit short-term.
Dr. Springer suggests a couple of weeks of psychotherapy follow- ing the injection. This will help any patients who have been taking drugs to deal with their post-traumatic stress move past the medica- tion, as well as develop someDr. Springer suggests a short course of psychotherapy following the injection. Post-traumatic stress chang- es the way you relate to loved ones and how you navigate the world around us. SGB opens up a window of opportunity to develop tools to manage the stress that will continue to come up on the job.
“Think of it as if you had knee surgery. You do physical therapy after,” Dr. Springer analogizes. “Because once people get calm in their own bodies, they still need to do the work of assessing and re- channeling the thinking and behavior that will create a prolonged trauma response.”
Having a prolonged trauma response. Feeling cool, calm and col- lected on the job. Better relationships with your spouse and family. Do you want this to be you? With the stellate ganglion block, it very well could be.
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