Tag Archives: psychoneuroimmunology

Candace Pert, Explorer of the Brain

Candace Pert, my favorite scientist, died recently from a heart attack…read the New York Times article.

Candace Pert, PhD.

Her book, Molecules of Emotion, had such an impact on me in terms of my work as a painter, and understanding the scientific basis of emotions on health and well-being. In fact, this blog, Creativity in Healthcare, was created based on the interconnectedness  of emotions on health and disease states. You may be interested in seeing a few paintings titled Molecules of Emotion“,  which focuses on the scientific work of Candace Pert.  This series remains a work in perpetual progress.

A bit of background on Candace Pert, PhD: 

As a  graduate student at John Hopkins University School of Medicine, Candace discovered the receptor for opiates like endorphins (natural opiate), morphine, opium, codeine and other pharmaceutical narcotics.  Her discovery  eventually won the coveted Lasker Award, a precursor to the Nobel Price, but was awarded to the chief laboratory scientist, i.e., her boss. Who knows what the real reasons were for Dr. Pert not being awarded the Lasker Award, but she certainly didn’t get the recognition she so deserved!

Recommended Reading and Listening by Candace Pert, PhD.

I strongly recommend Dr. Pert’s book and audio lecture for those interested in learning more about the biochemistry of how emotions affect states of health.

  • Molecules of Emotion:The Science Behind Mind-Body Medicine
  • Your Body is Your Subconscious Mind (audio lecture)

Both are available through candacepert.com and many online book stores.

        Your-body-is-your-subconscious-mind-by-CandacePertPhD

Using Creativity and the Arts to Heal Patients (and staff)…

What is creativity?  What does it mean to be creative?  The word or phrase is usually associated with artists and artist types, be they painters, dancers, musicians, writers, crafters and comedians.  It’s a word that is becoming commonplace…a buzz word relevant to the times and uttered by businesses, academics, the public and by those you least expect to murmur ‘creative.’  Everyone  is using  ‘creativity’ and ‘creative’ to describe a way of strategizing and problem-solving work and personal goals.  It’s no different in healthcare.

Here’s a few thoughts and definitions on creativity…

Creativity is marked by the ability or power to create,  to bring into existence, to invest with a new form, to produce through imaginative skill, to make or bring into existence something new. ~Mirriam-Webster

The ability to make new combinations of social worth.  ~John Haefele (CEO and entrepreneur)

The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.  ~Albert Einstein 

Creativity is fundamental to human experience. ~David Bohm

 And here are my thoughts on creativity and the arts in healthcare.  Through exposure and participation in the creative process and the arts, it promotes unity within oneself and with others, be it families, spouses, extended family, and all of those who connect with us.  Creativity and the arts ultimately embraces and promotes social peace.  Engaging in creative activities, whether actively or passively, brings forth…

  • compassion
  •  tolerance
  • kindness
  • harmony
  • expansion
  • growth
  • healing on multiple dimensions: body-mind-soul-emotion
  • collaboration
  • respect

This multi-dimensional healing begins on an individual level and ripples out to include neighborhoods, states, national and global communities.  What happens when you toss a pebble or small stone into calm waters?  It creates ripples or waves in the water  and radiates outward until the energy of the wave dissipates.  Creative activities creates creative energy and momentum, and all its associated benefits.

Creativity  isn’t just about thinking of new strategies to fix old problems or to heal old wounds.  It’s a different way of thinking, which brings about a new way of acting, behaving and interacting with others – it’s a natural and humanistic way of life.  By taking creative action, it can dramatically challenge our existing belief systems, our values, and encourage us to take risks we normally wouldn’t take (both in thought and action). 

Creative actions and creative interventions are what’s needed in healthcare…in patient care…in caring for healthcare professionals and staff…caring for local communities.

Creativity in Healthcare = Healing = Individual and Social Peace

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A Few Examples of Creative Programs in Healthcare…

Here’s how creativity and the creative process are being implemented in a few health systems.  In U.S. News (2006), a series of articles titled “The Fine Art of Healing the Sick”  highlights a growing trend of using the arts and the creative modalities to help patients alleivate stress, anxiety, provide diversional activities and to heal.  The side benefits of participating, whether active or passive,  vibrates out to include all persons within the healthcare organization…patients, families, healthcare professionals, para-professionals,  staff,  administration, consultants and local communities. 

Here’s a few examples of the methods used to integrate the arts into patient care (but read the U.S. News article!).  (Larson C. The Fine Art of Healing the Sick: Embracing the benefits of writing, music, and art. U.S. News/Best Health, June 5, 2006.)

 

1. A t the Louis Armstrong Center for Music and Medicine, which is a part of Beth Israel Medical Center in New York, it provides music therapy and researches its effects on children with asthma and adults with cardiac and pulmonary problems, and treats the musicians with medical problems.

2. Tallahassee Memorial Healthcare has medical music therapists providing music therapy sessions to their pediatric patients during diagnostic testing.  The result?  No wiggling, quirming or crying during the test.  No need to repeat tests or extend employee work hours which ultimately saves money for the hospital.

3. Sutter Health System in Sacramento, California offers six writing groups a week through its Literature, Arts, and Medicine Program for patients, caregivers, and the local community.  Studies validate both writing and visual art plays a role in reducing pain and decrease physical symptoms of illness.  One physician who refers many patients to the writing group stated she had a patient with severe asthma and chronic lung disease joined the writing group has improved her symptoms and well-being.  Note: engaging in creative work does not cure physical illnesses, but helps heal on a multi-dimensional level: physically, intellectually, emotionally and spiritually.

These creative programs are part of a growing trend to incorporate writing, music and the visual arts into the clinical treatment of patients, a.k.a  patient care.  Here’s a few other creative interventions to incorporate into healthcare organizations:

  • Laughing Clubs
  • Artist-in-Residence program
  • Writing
  • Music
  • Dance
  • Humor
  • Creative exhibits with work created by patients, families, staff and healthcare professionals
  • Drumming circles
  • Indoor and outdoor gardens
  • Art at the bedside for patients and families

Remember, creative interventions are not just for patients and families.  Providing patient care, whether by nurses, physicians, PT, OT, counselors, social workers, patient transporters, dietary aides, housekeeping staff can be physically demanding, emotionally draining and sometimes thankless.  A creative healthcare organization takes care of not only patients, but also its professional and para-professional staff.

“Creativity and Arts in Healthcare” gains support in Kentucky!

Kentucky Center

Here’s an arts organization working to instill art into the healing process – Kentucky Performing Arts Center in Louisville.    In the fall of last year, Norton Hospital and James Graham Brown Cancer Center  in Louisville collaborated with Kentucky Center to have artists work at their healthcare facilites for a short-time with funding from the Humana Foundation.  The premise of the program was to provide diversional activities in the form of arts to patients, thereby helping them feel better.  Finally, a few more  businesses who ‘get it!”

Robin Glazer of the Creative Center in New York knows first hand how creating art helps patients feel better and stated in the article, ” but not all health facilities are willing to invest in these kinds of arts programs.  This is a hard sell for a community that’s never heard of it before.”

However, there are many hospital systems with art and music programs, but what differs between the healthcare facilities in Louisville and the Creative Center and other arts in healthcare programs is,  education in a healthcare discipline.  For example,  Kentucky Performing Arts Center and the Creative Center uses local artists  in providing artistic services to patients.  In both organizations, the “intent of the program is to provide opportunities for patients, their families, for staff to encounter the arts, to have an artistic experience, that we believe will enhance their healing process,” according to the Kentucky Center program director.  Other arts in healthcare programs are structured around the nursing, therapeutic and holistic  models where healthcare professionals are also artists, and may have undergone additional study and/or certification in arts in healthcare courses, and  integrate local artists into their programs.  The model and intent of creative programs will depend on the healthcare organization’s leaders.

Is additional study in this emerging and growing field necessary?  Not necessarily, but I think certification or additonal study will become a trend.  In healthcare, academic achievement in one’s profession is a driving force for many professionals in order to differentiate themselves and to excel in their field.  So, obtaining certifications in developing, facilitating and implementing creativity and the arts for patients and families is not surprising to me at all.

For upcoming posts, I will research whether there are any creative programs in healthcare organization in Georgia, and tell you my findings.  It should be interesting to see who does or doesn’t have creative programs, and whether they’re large, small, educational or innovative healthcare institutions.

Is it Art Therapy?

When I conduct the Creativity Workshops in healthcare environments, someone never fails to ask me if I’m an art therapist – I am a Registered Nurse and artist.  People automatically assume, and understandbly so, one must be an art therapist when working or helping patients wih art.  As an artist and nurse, I want to introduce the idea and concept of what the arts can do for patients.  Engaging in the creative process, the arts, is healing and should be integrated into healing environments – into hospitals, outpatient treatment centers, doctors’ offices, the VA, residental centers, long-term care facilities (nursing homes), home care, and hospices.

When you engage in a creativity activity, aka the creative process, you become your own therapist.  The therapy (which you facilitate) is to access that space that is intuitive, invisible, intangible, healing, and brings you comfort and pleasure by creating a tangible object.  It can be a painting (in my case), a beautiful garden, poetry, a book or journal, a crafted piece of work, a short story, playing music, singing, helping others, drumming – the medium is not important.  Whatever you are experiencing or feeling will manifest outwardly in your creative project.  Now, this is not to say art therapy is not necessary…it may be for certain individuals who need individualized professional counseling. 

So, the question of “Is it art therapy?” still remains unanswered.  The answer is “yes”, but not in the traditional sense of the title ‘art therapy.’  The nurse/artist/social worker/physician/creativity facilitator is an advocate of creativity by facilitating and encouraging art-making… the patient is her/his own therapist by willingly engaging in the creative process…the therapy is the actual art-making itself.

From review of the literature, incorporating creativity into nursing’s framework of care is more practical, versatile and non-threatening over other therapeutic models, i.e., therapy.  In nursing terms, creative activities can be referred to as “creative nursing interventions.”  Traditional psychotherapy may not provide the best approach to working with patients, because most patients do not view themselves as needing psychotherapy.  Engaging in the creative process is what facilitates healing at the spiritual, emotional, cognitive and physical levels.  In fact, many patients may feel threatened if an arts program is referred to as art therapy.  Rather, patients want to gain a sense of control of an unfamiliar environment. (1)

Email me if you want the bibliography.

“Narrative Medicine: Healing the Healer” – an interactive Creativity Workshop for Healthcare Professionals

Back in September, September 3 to be exact, Bob Climko, MD, MBA  and I facilitated a Creativity Workshop titled “Narrative Medicine: Healing the Healer” for healthcare professionals.  This 3rd annual conference held by Georgia School for Addiction Studies titled ‘Keys to Change: Prevention, Treatment and Recovery’ could not have been more appropiate as our world adapts to changing paradigms in current economic, leadership, social and personal transformations in vision, mission and attitudes.

In healthcare, change is also occurring, albeit slowly.  But positive change, no matter the pace, is good.  Historically, Nightingalethe medical model – a world of scientific and technological breakthroughs to ‘cure’ human conditions – prevailed.  And the ‘art’ of healing the sick, utilitzing nature and the arts, and honoring human dignity – lost.  However, there is a stirring in healthcare to provide services that are truly patient centered and to focus on multi-dimensional healing.  And the concept of integrating nature, creativity and the arts in healthcare are a couple of these services.   Other terms for these ‘newer’ services are: complementary therapies, integrative medicine, alternative therapies, etc.  But, these therapies are not new…they existed since Hippocrates2the beginning of time.  Both Hippocrates and Florence Nightingale believed in treating patients as multi-dimensional beings by addressing the physical, intellectual, spiritual and emotional realms.  They believed in the benefits of nature, lighting and the arts as important components to the healing process.

Active participation in creativity and the arts by patients, families, staff, healthcare professionals and the larger commUNITY encourages collaboration, harmony, tolerance of differing opinions and viewpoints, acceptance, acknowledges and appreciates the creative process, flexibility and patience.

 

music-notes1writing-colorpaintbrushes

Now, back to “Healing the Healer”  Creativity Workshop!

Purpose of the Workshop:

1. The use of the written word and art activity as healing interventions.  Through careful listening to one another’s stories through the written and spoken word, and process of art making and presentation, healthcare professionals (healers) may begin to reconnect with their own healing spirit.

2. To introduce, promote and utilize the concept of integrating creativity and the arts into clincal practice.

Description of the Workshop:

Two arts activites, writing and art-making, were chosen for participants (18 healthcare professionals) to tell and show why they chose to enter healing professions for their careers. The writing portion was  conducted by Bob Climko, MD, MBA and the art-making by Marti Hand, RN, MPA, Artist.  Writing, as explained by Dr. Climko, was the third ear.  Creating art accesses the soul and heart regions of the body.

Savannh

(Healthcare professionals creating their masks during “Healing the Healer” workshop)

Outcome:

The healing professionals wrote poignant stories of particular clients/patients who they treated and left a lasting impression – these were the reasons why participants entered the professions they did.

In the art making activity, the instructions were to create masks representing their reasons to become healthcare professionals.  Interestingly, there was not a single person who followed the guidelines!  Rather, all the masks created represented their current physical, psychological, spiritual and emotional states.  Most participants explained their masks, and then told the story behind the masks…something I believe would not have happened without the art-making piece.

Active  participation in the creative process enhances collaboration, harmony, tolerance, acceptance, flexibility, and in this case – catharsis.

GSAS-mask

(Example of mask created by “Healing the Healer” participant)

By implementing creativity and the arts in healthcare systems, patients, families, staff, healthcare professionals and local communities all benefit:

Art-making

Writing

Music

Dance

Humor

Laughing Clubs

Art exhibits with work created by patients, families, staff and healthcare professionals

Drumming circles

Indoor and outdoor gardens

Art at the bedside for patients and families

drummusic-notes1singing

Turning Swords to Paintbrushes, and Warriors to Painters…

          paintbrushes1

On October 12, 2009, the New York Times published an article titled “Turning Swords to Pens, and Warriors to Writers.”  The story summarizes an effort organized by the Writers Guild of America in mentoring wounded U.S. military veterans to write their stories.  The writing workshop received support from the Wounded Warrior Project, and the National Endowment for the Arts Operation Homecoming.  Below is a summary of the article, some information on traumatic brain injury (TBI),traumatic brain injury and my recommendation to offer painting  and the visual arts as a healing modality for self-expression of the horrors and psychic wounds of war.

Here’s are few veterans’ responses on the writing workshop…

  • One veteran struggled to find what exactly it was that he wanted to say.
  • Another said “…there’s something in my heart…I feel like it’s a calling to write.”
  • Yet, another veteran’s real reason for attending the writing workshop was to sharpen her writing skills for a historical compilation of her family history, and the role America plays in their lives.

Writing offers veterans an avenue for expressing personal stories and experiences of combat, and is a fine medium for those capable and desiring to write.  However,  for veterans with traumatic brain severe-nerve-damageinjuries, writing may not be the best arts modality to offer due to nerve damage or loss of neural connections within the brain. This loss of neural connections may lead to many of the symptoms associated with brain injuries. Depending on the location,  severity, and rapidness of treatment for traumatic brain injuries, there may be difficulties with the following (in relationship to writing).

  • Inability to focus on task
  • Difficulty with problem solving
  • Inability to express language (Broca’s Aphasia)
  • Slower thinking
  • Inability to attend to more than one object at a time
  • Inability to name an object (Anomia)
  • Inability to locate the words for writing (Agraphia)
  • Problems with reading (Alexia)
  • Inability to focus visual attention
  • Difficulties with eye and hand coordination

 (Source: Brain Injury Association of America www.biasusa.org)

To learn more about the other myriad symptoms associated with traumatic brain injuries in the military, visit the link below – DHCC.

According to DHCC  (Deployment Health Clinical Center) , the website states that early mild TBI symptoms may appear subtle, but they can lead to significant, life-long impairment in an individual’s ability to function physically, cognitively and emotionally.  Btw, DHCC is located at Walter Reed Army Medical Center in Washington, DC.

In a New England Journal of Medicine article on TBI in the military, it  Iraq-Soldiers-PTSD15dec04reported 56%  of those diagnosed with TBI are considered moderate or severe, and 44% mildAlso, some symptoms of TBI overlap with those of post-traumatic stress disorder (PSTD).  Those in the military are usually young and healthy, and have a good chance to recover from TBI.  However, they have been hurt in terrible ways which may complicate and affect their recovery outcome. (1)

Use paintbrushes rather than pens…

Given the cognitive, visual and motor coordination problems veterans paintbrushesexperience as a result of TBI, writing may not be the best avenue for self-expression.  Painting (and the visual arts) as a creative intervention is a much better choice of medium.  Why?

  • With writing, there is a tendency for  internal editing and censoring of the written word, and this is by those of us without brain injuries!  Imagine the frusration of veterans suffering from mild to moderate  symptoms of  TBI.
  • Writing requires fine eye – hand coordination. Painting, on the other hand,  involves more gross motor coordination.
  • Painting requires less cognitive and visual perfection or acuity.  For example, Claude Monet painted despite his progressing blindness.

Claude Monet water lilies

(Claude Monet, water lilies, 1840-1926)

  • Painting utilizes imagery rather than words to express psychological and emotional states.
  • In painting, there is no right or wrong methods, techniques or colors to convey meaning and thoughts.  Writing requires concentrated effort, exactness and command of the written language.
  • Paintbrush handles can be adapted for those unable to hold thin paintbrushes.
  • There is less internal editing with painting.

Email me if you want the bibliography.

Try this simple Creative Intervention…

music-notes1I’d like to introduce and describe a short and simple Creative Intervention to try on your own.  I developed this CI (Creative Intervention) for use in my Creativity Workshops. 

The goal is to visualize the music you hear and transfer these images onto paper.  It will take about 10 minutes to complete the music-notes1exercise, but may be longer depending on how much time is devoted to your drawing; the musical piece is 5:25 minutes long.

But first, read the short list of instructions and then go for it! 

A few Instructions:

1. The music selected for this particular Creative Intervention is Beethoven’s Pathetique Movement 2 by Freddy Kempf.  I chose Freddy beethovenKempf’s version over other artists for his expressiveness and sensitivity in interpeting this piece.

The link below is to a youtube video.  The goal is to listen with your eyes closed. No peeking to watch Freddy during this exercise; you can watch him later!

Note: It’s important to be in an quiet environment for you to benefit from this exercise.  So, close your office door or wait for better time.

2. Gather your supplies: white paper and drawing/coloring tools in different colors (crayons, colored pencils or markers).  Anything you crayonscan draw with is fine, but make sure you have different colors.

3. Listen to the selected piece by clicking on the link. Remember- keep your eyes closed during the entire musical piece.  The goal is to shut out outside visual images and noises, and focus on you.

While you’re listening, picture how the music would look if you could see it.  What are the colors and shapes you see?  Are there lines?  Is it abstract?  What are the rhythms, the melodies and mood(s) you see?  How does the music make you feel?  Are there words or just colors or images? Don’t worry about drawing anything you may not recognize – that’s not important to this exercise.  Remember, there is no right or wrong way of doing this exercise – just your way.

music-notes1

      Are you ready to begin?

Increase the volume on your computer to mid-way – Beethoven’s Pathetique Movement 2 is very soft in certain sections.

CLOSE YOUR EYES and listen for the entire duration.  Click the youtube link below and listen to Freddy Kempf’s version Beethoven’s of Pathetique Movement 2.   According to music interpretation,  Pathetique in its entirety is not a sad song piece.   Beethoven wrote this when he found out he was losing his hearing. The first movement is depicting the rage and sorrow he felt. The  second movement (the youtube video below) is depicting the comfort he receives.  The third movement is almost a testament of joy.


Now, draw what you ‘saw’ when your eyes were closed.  When you’re finished, look at your drawing for a few minutes.  Don’t be critical about it – it is what it is.  Try this exercise with your favorite musical pieces – rock, alternative, classical, pop, etc.  Compare the 2nd, 3rd drawing with the first.

Creative Interventions are not just for patients…

Creative Interventions should be experienced by all healthcare professionals, not just patients.  Who will benefit?  Nurses, doctors, ancillary nursing personnel, social workers, OT, PT, healthcare managers and executive staff, and academicians.  By experiencing and expanding your own definition of creativity, it will ultimately benefit your patients and your daily interactions with others.

 mhand_stem-cell-garden_sm(stem cell garden, Marti Hand 2008)

Your Body as Healer…

An article titled “Miracle Survivors,” in Forbes (March 2, 2009), portrays stories of people who have spontaneous remissions from several different types of cancers. Explanations by the medical community range from “…a complete mystery,” “divine intervention,” or “the immune system.”  With regard to the latter explanation, our bodies have all the necessary elements to heal itself. 

Everyone knows who Deepak Chopra  is…here is his explanation and understanding of spontaneous remission taken from intentblog

“Essentially remission is based on our understanding of the science of self-repair. Our bodies have learned to heal themselves over millions of years of mhand_bodymindsoulemotionevolutionary time. Our bodies are the best pharmacies in nature. They make antibodies, sleeping pills, tranquilizers, immunomodulators, and anti-cancer drugs in the precise dose at the precise time and for the right taget organ; and all the instructions come in the packaging! The “packaging” is your own inner self – the ultimate and supreme genius which mirrors the wisdom of the universe.  Cognition or thinking, moods, feelings and emotions, behavior, social interactions, personal relationships, environment, diet, and the inner world of consciousness including attention and intentionality all influence the biology of healing.”

Now, back to the Forbes article…

It states that “spontaneous remissions are among the rarest and most mysterious events in medicine, with only several hundred cases that can be considered well documented.”  In 1993, two authors for the Institute of Noetic Sciences, created a database of  medically reported cases of spontaneous remission in the world from more than 3,500 references.  This data shows the ability of our bodies to heal itself is not such a rare event. 

Btw, the authors defined spontaneous remission as “the disappearance, complete or incomplete, of a disease or cancer without medical treatment or treatment that is considered inadequate to produce the resulting  disappearance of disease symptoms or tumor.” 

Activate the body’s self-healing properties with Creative Interventions in Patient Care:

  • Art-making
  • Writing
  • Music
  • Dance
  • Humor
  • Laughing Clubs
  • Art Exhibits with artwork created by patients, families, professional staff
  • Indoor and outdoor gardens
  • Art at the bedside
  • Limitless possibilities

 writingpaintpalette1flower-butterfly

Some Messages for Contemporary Medicine…

A little humor for the day by Groucho Marx:

 “I never forget a face, but in your case, I’ll be glad to make an exception.”

I recently read an article written by two physicians in Greece titled, “The Modern Hippocratic Tradition: Some Messages for Contemporary Medicine.”  The article provides background information on Hippocrates and his major achievements in medicine, namely, modern medical practice of attributing disease to natural causes, and treating based on observations, reasoning, and experience.  However, Hippocrates believed and treated his clientele as psychosomatic entities, a holistic medical approach, unlike modern medicine practice which is very depersonalizing and singularly focused on treating the body – not the whole person.

There are many fine points on the state of current medicine (undesireable) and the need for the medical establishment (and healthcare in general) to return to and embrace the basic philosophy and principles of Hippocrates.  Here, I will mention a few by putting the points in quotation marks.  But, read the entire article which you will find interesting.  Source: Marketos S, MD and Skiadas P, MD.  The Modern Hippocratic Tradition: Some Messages for Contemporary Medicine. Spine 1999;24(11):1159-1163.

“…In our times, there is a tendency to forget that the patient must occupy the center of our attention, and in forgetting this principle, physicians have almost lost control of their profession.  The innovation that Hippocrates introduced to medicine was the holistic approach to the patient…he considered and treated the patient as a psychosomatic entity and not as a mere sum of organs…”

“He believed that the human body acts as a whole, so that when an organ is ill, the whole body is being afflicted.”

Hippocrates had a strong faith in nature’s healing power.  He observed the course of  the disease, trying not to interfere with nature.  This attitude should not be explained as a passive stand toward the healing process, but as a respect for nature’s power to cure.  One of his principles is, “Merely give nature a chance, and most of the diseases will cure themselves.”

“Interest has shifted from clinical evaluation of the patients to the assessment and interpetation of sophisticated procedures. In many cases, the efficacy of advanced medical means is being overestimated.  Apart from the fact that exaggerated trust in technology can lead sometimes to inevitable mistakes, this attitude tends to alienate physicians from their target, namely the patient.”

“…the fragmentation of medical science has created a type of physician who regards the patient as a disordered mechanism rather than a psychosomatic entity…”

Hippocrates believed ,”the physician must assist nature, which is the physician of the diseases.”  The natural environment is constantly and rapidly being degradated through contamination of water and food, accumulation of chemicals, nuclear pollution, and the spread of radiation.  The consequences of these environmental changes are apparent already.  Cancer and cardiovascular disease affect a great percentage of Western countries.  This undeniable reality prompts us to rediscover the principles regarding healthful behavior, the quality of life, and the healing power of nature.”

“…biomedical technology has ignored the psychosociologic aspect, treating the patient more or less as a disease and not a unique human entity.  Depersonalization of the patient and a lost sense of his or her individuality can be confronted by keeping the Hippocratic humanistic values in perfect balance with progress in technology.”

“…medicine more than ever senses the need to combine the concepts of humanistic values and the Hippocratic messages with the techonoloic ‘imperative’ (power).  This bond is necessary to the improvement of medicine in the future because, currently, the enormous biomedical technology so far has contributed little to the traditionally human fields of psychosomatic and functional disturbances, posing new dilemmas and threatening scientific problems.”

So, what do YOU think about all this…?

 

Lingering effects after the I.C.U

Have you had a family member or friend stay in the I.C.U (intensive care unit) for treatment of an illness?  Those of us who work in theICU critical care units (past tense in my case) are happy to see patients tranferred to step-down units because we feel we applied our best efforts in getting these patients on the road to recovery…and we did.  We stablized their bodies and healed them physically, but researchers are finding out that spending days, weeks or months on life support in the units can bring unexpected, long-lasting undesireable effects.

According to a New York Times article (Jan. 11, 2009), some patients  experience lingering effects from staying in the ICU for months to years after they are discharged from the hospital, such as:

  • Lingering generalized weakness
  • 25% of patients on mechanical ventiliation for a minimum of 5 days got so weak, they were unable to lift their arms
  • Poor concentration
  • Significant weight loss
  • Some patients experienced symptoms of PTSD (post traumatic nightmarestress disorder) such as hallucinations, nightmares during sedation, mood disorders, anxiety, shortness of temper and frightening memories – click here for symptoms of PTSD in a previous post.

Dr. Dale Needham at John Hopkins has begun a 5 year study of patients discharged from the hospital and is finding many patients have difficulty in regaining their strength.  Families are finding their loved one(s) are not the same person anymore.  The difficultly lies in determining which disabilities come from the illnes as opposed to the I.C.U stay, when many patients are on a mechanical ventilator, and receives high doses of sedatives, narcotics and anesthetics.  Particularly surprising is how quickly patients loose their strength.

Patients in intensive care not only experience physical stress due to SleepDeprivedbodily trauma, but also psychosocial stressors with pain, inability to communicate, sleep deprivation, feelings of isolation or lonliness, and fear or anxiety being the most common.  A review of the literature has shown each of these stressors are associated with decreased immune functioning. (2)

In  Laitinen’s study, patients emphasized the importance and need of closeness with a healthcare professional whom they could trust to reduce feelings of anxiety, isolation and increased sense of security. (3)

 

And how are medical professionals addressing these issues? 

By…

  • reducing sedation levels of pain medications, narcotics and anesthetics.
  • getting patients mobilized and walking along with all the ICU paraphernalia like intravenous lines, ventilators, and monitoring equipment.
  • mobilizing patients as soon as possible – patients seem to recover faster and spend less time in the intensive care and the hospital.  

music-notes1music-notes1music-notes1

Implement Creative Interventions for patients in the intensive care units

I encourage the use of Creative Interventions as non-invasive modalities to counter the psychosocial stressors and loss of strength patients experience during their intensive care stay.  Families and CB030187friends can help by bringing the supplies listed below, and more importantly, become active participants in their family member’s care.

Naturally, not all patients in the intensive care units will be capable of actively participating in creative interventions due to their conditions.   However, applying a headset to unconscious patients and playing soft soothing music is much better than hearing noxious noises and sounds of ICUs. 

Here are a few Creative Interventions to start with:

  1. Headset,  ipod or CD player.  Encourage families and friends to compose the patient’s favorite playlist (soft and classical music music-notes1are best), and play during visiting hours.  Nursing staff can apply this intervention during non-visiting hours.  I wrote several posts on the benefits of listening to music in reducing anxiety, pain, and as a form of relaxation.  The posts are titled, Rx: Listen to Music, Listening to Music: Another Creative Intervention.
  2. Listening to music with headsets also reduces noise inherent in intensive care units.
  3. Art-making activities: encourage families and friends to bring in simple art-making materials, such as watercolor markers and sketch pad or other creative materials. 
  4. Engaging patients in creative activities provides a sense of enjoyment, pleasure and diversion in a bewildering and frightening environment.                                                                                                                                                                                                                                     
  5. Give a lump of clay to patients with strokes (or any patient) to create small sculptures.  By manipulating the clay with their hands, the physical motions will help with maintaining muscle strength, dexerity, and divert their attention from their current situation.                                                                                                                                                                                                                                                                                     dog mask

 

Note: email me if you want the bibliography.