Thursday, February 13, 2014

New BBC Horizon documentary investigates the healing power of the mind: Patients who had FAKE surgery for a broken back recovered just as well, documentary reveals

Patients who had FAKE surgery for a broken back recovered just as well, documentary reveals
We’ve all heard of placebos. They’re dummy pills. They can’t do anything real. After all, there’s nothing in them.

At least, that’s what we thought.

But in recent years, evidence has built up to suggest that placebos can be highly effective – particularly in treating pain, depression, and even alleviating some of the symptoms of Parkinson’s disease.

And it isn’t just dummy pills that seem to be able to work: you could get life-changing improvements from a pretend potion that’s actually just water; or perhaps fake acupuncture with needles that don’t even puncture your skin.

The key is simply that you think it might help you.

But when it comes to placebos, it doesn’t get much more dramatic than what’s been called sham surgery – as Dr David Kallmes discovered a few years ago.

He’s a successful radiologist at the Mayo Clinic, one of the world’s leading hospitals – it’s where the Presidents of the United States often get treated.

For the past 15 years, he’s been fixing broken backs by injecting them with a special kind of medical cement.

Dr Kallmes regularly performed the procedure – called vertebroplasty – and found it hugely effective.
'We saw terrific results from the procedure, really amazing results,' he told me.

However, there were some questions as to exactly what was going on – because some people seemed to get better even when the operations went horribly wrong.

We’ve all heard of those calamitous procedures where someone has the wrong leg amputated. Well occasionally, people in need of vertebroplasty had the wrong vertebra filled with cement.
And yet it still worked.

As Dr Kallmes rather delicately puts it: 'There was some reason to suspect that there were numerous factors at play in the apparent effectiveness of the cement'.

He decided to do something very unusual – something that most doctors would be incredibly nervous about, but something that a good scientist can’t resist: he decided to conduct an experiment to see whether vertebroplasty was any more effective than a placebo.

He designed a trial in which some patients would be given genuine vertebroplasty, and some would be given a placebo.

But in this case the placebo couldn’t be a dummy pill, it would have to be a fake operation.
It was important that the 130 patients on the trial didn’t know whether they were having the real thing or the placebo.

This meant that Dr Kallmes had to develop an elaborate ruse to ensure that patients wouldn’t work out which group they were in.

All patients were prepared for their ‘operation’ in the same way; they were wheeled into theatre, and given a local anaesthetic in their back.

It was only at that stage that it was decided whether or not they’d have the placebo or the vertebroplasty, and it was a computer that randomly decided their future.

Even the doctors didn’t yet know whether they were about to perform a real procedure, or whether they’d just be pretending.

'In both cases,' says Kallmes, 'No matter how they were randomised [i.e. which operation they were having, the real or the fake], we then opened the cement, which has a very strong odour like nail polish remover, to really simulate it for everybody in the room.'
Half the patients then received the real operation; the other half experienced theatre, but not of the operating kind.

Dr Kallmes explains: 'If they were randomised to placebo, we had a script that we followed, we pressed on the back and said okay ma’am, the cement is going in now, everything’s going fine, things are going well, a few more minutes here, okay we're all done.'
It almost sounds like a child’s game of doctors and nurses.

For Bonnie Anderson, one of the patients on the trial, it would have seemed impossible that play-acting could give her the relief she needed.

After slipping in her kitchen, she’d cracked a vertebra and was in immense pain, barely able to move. 'I couldn’t stand up straight, I’d have to hold onto something. The pain was just very, very severe,' she said.

What’s more, Bonnie had actually had a real vertebroplasty the year before, when a different vertebra had fractured. She knew what to expect from the procedure. It wouldn’t be easy to fool her.
And yet for Bonnie, the effectiveness of the placebo – though she didn’t know that’s what it was – was clear. 'Within a week….I was able to play golf, I took it a little easy, but I was able to play golf almost every day.'

At 76 years old, as she was at the time of the trial, a game of golf every day suggests a fairly effective operation…

In fact, Bonnie noticed no difference in pain relief between the real thing, and the placebo.


Read more: http://www.dailymail.co.uk/health/article-2558438/The-remarkable-power-PLACEBO-effect-Patients-FAKE-surgery-broken-recovered-just-documentary-reveals.html#ixzz2tFHhw1CU 

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