It is unfortunate that SGB is being hyped up for PTSD so much online and on television at this early juncture. I've had a few veterans express dissatisfaction and disgust that the VA is not providing SGB already. To be fair, these same folks are smoking weed like there is no tomorrow, seeking relief from that instead of doing the difficult work of therapy.
The article in JAMA Psychiatry on November 6th isn't actually all that impressive to me, showing only moderate improvement in PTSD at 8 weeks. I'm concerned this study isn't very generalizable since only 113 active duty military members were the population, also for this short duration of time.
I'll be more interested when they complete the proposed year long study with a larger and more diverse population. Until then, I consider it the flavor of the month. Most likely it will end up like vagal nerve stimulation in usage for depression - too expensive, too inconvenient, too many adverse events, and not helpful enough to justify use in most patients.
Hi there. I just came across your post today. I wonder if you know that many many times, even with "the hard work of therapy," with ptsd and s-ptsd, there is no end, no recovery, and no relief. Medically and Psychologically speaking from experience, over 30 years under my belt of more kinds and types of therapy than you might imagine, the intrusive, debilitating symptoms keep coming, repeat their instances, and your words in quotes sound very judgemental, and imply the hard work of therapy is/will cure. That, unfortunately, for as many as not, simply is bad advice. I cannot say that the publishing of the ganglion block by 60 minutes/The VA via research, etc., is misleading, successful or unsuccessful, because as with most mental/neuroligical illnesses, even MD's, who have learned some things about PTSD et al, have little real-world clue. Bear with me, please? The effects of ptsd on post surgical care, L&D, and chronic pain is profound. All the brain registers is having been compromised by gen anesthesia, recovery, and so on, so it hyper-ramps pain signals in efgort to protect; to move. For instance, double tkj replacements make moving around, and commanding ones body and environment, which quells that automomic response, nearly unplausable for most medical profesdionals to comprehend, the hospitals are 9/10ths about their liability, and so, the patientbis given benzos to calm them, and/or more pain meds, which only makes the patient's suffering worse. The brain fights its being compromised, and so around and around we go. Countless times, I (the patient in these examples,) after counseling the anesthesia team, surgeon, and repeating all to everyone involved in my care, I have been unable to move, but hear everything. I wake up hyper fast. I have a congenital collagen disorder, so 14 major orthopedic surgeries under my belt, I can say with every confidence, from rural farming central minnesota, to Mayo Clinic in Rochester, to Jacksonville, FL, ND, Milwaukee, WI...... the actual manifestation of jow ptsd changes the brain, is not understood by the vast majority of clinitians anywhere. There is no cure for many. I choose to view the stellate ganglion block as hopeful progress towards a cure, because no amount of hard work illicits a cure or measurable mitigation for lots of ptsd survivors. Please try to understand that by imagining yourself with ptsd, plugged into resources and therapy, and having to accept the fact that at present, its as good as it is going to get. When comparing my best days to the population without ptsd, my best, are their unemaginable worst. It is far more than clinical rotations, book learning or entire semesters dedicated to understanding it. I promise you that when you think "you know," you certainly do not know entire light-years more than what you believe you do. I promise that. I hope you find this helpful in some way, stay safe, and thank you for deciding to become a Doctor. Its definitely a calling. m.d.
