I find your comments very interesting, Mel
I read your pages about your recovery post CABG too: a real eye-opener.
The hospital I work at does not make much use of the psychological methods
of pain management you mention as far as I'm aware. One of the nurses was
doing a trial of the use of aromatherapy massage post CABG .... not sure of
the results.
I think perhaps physio's instictively use techniques such as breathing
control (in the UK physio's are taught this as well as relaxation
techniques) with patients who are in pain. But I'm afraid we tend to reach
straight for the drug chart in the early stages of recovery when pain is a
problem. What exactly did you mean by therapeutic touch? You didn't mention
acupuncture as a means of relieving post-op pain. Does anyone on the list
have experience of using this?
Perhaps the day will come when we will let our patients choose their
preferred method of pain relief pre-op so that they can be made familiar
with that technique before admission! Has anyone done a study on the use of
Walkmans during hospital admission? I can see it could be very useful in
critical care units to block out the sound of all those alarms.
Kate Stevens
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: 02 April 2000 16:28
Subject: CARDIAC SURGERY REHAB
> On dated 4/2/00, Stewart Harrison< [log in to unmask]> wrote:
>
> << I treated a chap as an outpatient, post CABG, with VERY tender chest
scars
> which responded positively, in the short term at least, to TNS. Have you
> tried this yet? Unfortunately I left the post shortly afterwards and so
do
> not know whether any long term benefit was achieved. >>
>
> ***Were you not a little concerned that the electrical stimulation might
> disrupt the cardiac rhythm which often tends to be unstable in CABG
patients?
> Did you use very small voltages and currents? Those chest scars and
> especially the traumatised split sternum really made life very painful
after
> my quadruple bypass surgery. I periodically applied microcurrent to avoid
any
> possible disturbance that the use of higher current devices might have
> caused. Anyway, the microcurrent definitely seemed to accelerate the
> superficial healing and diminish the pain, though, to this day, I have
> profoundly impaired sensation in the more central areas of my chest.
>
> However, I found that the normal types of analgesic like Tylenol
> (paracetamol) were a completely ineffectual in diminishing any of the
> post-surgical and later pain associated with cardiac surgery. Trying to
> sleep was a real misery. Using powerful narcotics was not an option
because
> of the risks posed to the heart, so I resorted to using a 'Walkman' to
> meditate to appropriate relaxing music, especially during the most painful
> periods after release from intensive care to high care.
>
> I was most surprised that none of the three clinics where I stayed for
> various procedures used psychological methods of pain and trauma
management.
> The wonderful Zulu nursing staff who spent many hours at my bedside really
> thought I was quite a strange white man, but it worked for me and that
gave
> them a bit of peace, too! Besides the direct effect that wearing music
> bearing headphones had on my pain and state of mind, the masking out of
the
> stressful sounds of other patient agonies and the ever-disturbing sounds
of
> ward activity really made life a lot more bearable during the month that I
> spent in hospital. After my discharge from hospital, I used Tai
Chi-like
> movements, Zen and other centering procedures, and these played a major
role
> during my early stages back towards normal strength and competitive
> weightlifting.
>
> Have any of you encountered hospitals that routinely make available
> psychophysiological modalities such as meditative music therapy,
> hypnotherapy, progressive relaxation, transcranial microcurrent analgesia
> ("electronarcosis"), therapeutic touch (I am not referring to any mystical
> hand waving that has drawn a lot of criticism) and breath control? How
much
> of this sort of intervention should be taught to physios during their
> academic undergraduate years? Should this remain within the realm of
> psychotherapy or should some of it be taught in other fields of medical
care?
> After all, the discipline of PNI (Psychoneuroimmunology) has been
accepted
> into aspects of mainstream medicine.
>
> Mel Siff
>
> Dr Mel C Siff
> Denver, USA
> [log in to unmask]
>
>
>
>
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