Thursday, May 2, 2024

STELLATE GANGLION BLOCK FOR PTSD & ANXIETY -by Dr. James Lynch

 ULTRASOUND GUIDED TREATMENT: STELLATE GANGLION BLOCK FOR PTSD & ANXIETY -by Dr. James Lynch

The stellate ganglion block (SGB) is a procedure in which an injection of a long-acting local anesthetic, using ultrasound guidance, is made in the side of the neck around the main nerve that controls the “fight or flight” response (the sympathetic nervous system). This nerve, (the cervical sympathetic chain) which is a two-way conduit, connects the parts of the brain that control the fight or flight response (referred to as the central autonomic network) to the rest of the body. By blocking or “turning off” the traffic in the cervical sympathetic chain, it is believed that the parts of the brain that control the fight or flight response are allowed to completely reset, resulting in long-term relief of the associated anxiety symptoms. Multiple peer-reviewed medical studies show that SGB results in significant long-term improvement in chronic anxiety symptoms associated with post-traumatic stress injury (PTSI). The SGB takes less than 15 minutes to perform, and benefits are seen in as little as 30 minutes.






STELLATE GANGLION BLOCK is a newer modality that’s being utilized for patients suffering from PTSD. Traditionally, my training in doing these procedures is in the setting of CRPS (complex regional pain syndrome), which is often a sympathetically mediated condition. There is mounting evidence demonstrating the benefits of using these treatments in patients that have sympathetic nervous system issues such as PTSD and CRPS.  We perform this procedure under direct image visualization to make sure that we get optimized outcomes for patients and do it in the safest possible way.  When I started doing this procedure for patients with PTSD I saw that many patients had significant improvement in their symptoms, particularly with presentations like anxiety or an overactive “fight or flight” response.   It's something that may take several treatments, but in many cases patients can feel benefit with the first treatment.  The results have been quite compelling.  This is something that can really help people meeting the appropriate criteria.

Author:
Dr. Matthew Kohler has been a leader in the field of Regenerative Medicine and Interventional Pain Medicine in Manhattan since his post-doctoral training in 2015. He completed both his residency in Anesthesiology and fellowship in Pain Medicine at the prestigious Columbia University Medical Center, part of New York City’s #1 ranked New York Presbyterian Hospital system. He is double-board certified in Anesthesiology and Pain Medicine through the American Board of Anesthesiology. Through his training he has garnered world-class experience in interventional spine and joint procedures for the management of painful degenerative conditions and injuries. (for complete info, visit: https://ospinamedical.com/dr-matthew-kohler)


How to Detect & Manage INFLAMMATION the Non-Invasive Way


Learn about the latest in non-invasive diagnostic imaging modalities and the current breakthroughs in personalized therapies with pulsed bioenergy regenerative science. The AngioFoundation, the Integrative Pain Healers Alliance, the Women's Diagnostic network and all branches of the NY Cancer Resource Society unites under a coalition called "WAR ON INFLAMMATION"- an educational, advocacy and research initiative in pursuit of resources and solutions to offer new informative support against the many chronic disorders of our day.  Additional support comes from the BioEnergy  Therapeutic community and the Paul Dreschnack Research Foundation exploring the many advantages of Extracellular Vesicles.  

VISUALIZING THE TREATMENT OF INFLAMMATION
The Answers Collected from Ultrasound Imaging

Historically speaking, the most favored (and sensible) way to identify the results of any treatment is by tracking the body's immediate response to it. Controlled testing must show the patient's condition PRE and POST effects, where true data-finding is collecting the necessary EVIDENCE of its claims. The investigator can pull a significant amount of data from this form of validation testing: including stage-by-stage bodily response to future projections of possible side effects.  Modern diagnostic science looks to imaging for its safe, non-invasive yet quantifiable analyses of what’s under the skin. In this latest review, ultrasound offers a flicker-free visual (10-30 frames per second) of muscle contraction.  The “real-time” advantage of video under a 3D Doppler Ultrasound easily and clearly shows the frequency of the muscle bundle’s firing (twitching) indicating fatigue and potential pathology.


WELLNESS ESSENTIALS: INFLAMMATION 101

Part of the complex biological response of body tissues to harmful stimuli (such as pathogens, damaged cells, or irritants) is inflammation. It is also a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and initiate tissue repair.

The five cardinal signs are heat, pain, redness, swelling, and loss of function. Inflammation is a generic response, and therefore it is considered as a mechanism of innate immunity. Too little inflammation could lead to progressive tissue destruction by the harmful stimulus (e.g. bacteria) and compromise the survival of the organism. In contrast, too much inflammation, in the form of chronic inflammation, is associated with various diseases, such as hay fever, periodontal disease, atherosclerosis, and osteoarthritis.

ACUTE inflammation is the initial response of the body to harmful stimuli from the blood into the injured tissues. A series of biochemical events propagates and matures the inflammatory response within the injured tissue. Prolonged or CHRONIC inflammation, leads to a progressive shift in the type of cells in the inflamed area and is characterized by simultaneous destruction & healing of the tissue from the inflammatory process.




QUANTITATIVE IMAGING CONFIRMS THERAPEUTIC RESPONSE
One of the most comprehensive ways to confirm the results of any treatment is by clinically tracking the body's physiological response from underneath the skin.  Diagnostic imaging captures measurable data about the injured or inflamed area, allowing both clinicians and patients the ability to identify therapeutic progress in real time.  Widely preferred scanning modalities include the Doppler Blood Flow Ultrasound (or sonography) and Elastography, both using high-frequency sound waves to view inside the body. Like an internal video camera, these high speed scanning innovations capture actual movement of the body's internal organs.  This offers a vast amount of biometric information about the patient’s condition, in comparison to still images of conventional x-rays. The ultrasound's ability to evaluate abnormalities within the soft tissue in research and clinical trials are widely used in recording  evidence-based biomarkers to trace therapeutic efficacy. 







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