VA Hospital Tries Alternatives To Pain Medications

The Veterans Hospital in White River Junction is trying out new programs designed to relieve pain without strong medications. VA doctors are now prescribing acupuncture, yoga and aquatic therapy as alternatives. 

 Acupuncture has not yet been fully integrated into the hospital’s menu of treatment options, but for about six months now, Dr. Freda Dreher has been inserting sterile needles not much thicker than a human hair into a few people looking for pain relief.

“So I will start with a needle right at the shoulder that’s been painful,” she said to Carol Hitchcock, Executive Assistant to the hospital Director.
Hitchcock is a veteran who has served in Afghanistan, but her excruciating shoulder injury resulted from a motorcycle accident many years ago.

“It just hurt so bad that I couldn’t do anything, and I tend to be pretty tolerant, but I couldn’t tolerate it any more,” Hitchcock recalled.

But she didn’t want to take powerful, potentially addicting pain killers either, especially since there is so much concern about opioids. So about once a month - it used to be once a week - she comes into this examining room and sits or lies down on a table to get non-medicinal relief.

After Dr. Dreher inserted about a half dozen micro-thin needles into her arm, the patient looked and sounded more relaxed.

“I sleep, which I hadn’t done for a number of years,” Hitchcock said. “I can actually sleep now because of this. The pain is not there. I guess it’s cyclical, right? So I feel better, so I am healthier, so I sleep better and my weight is under control now, so everything just aligns."
Sometimes, Hitchcock said, the pain disappears instantly. Other times, as on this day, it slowly wanes through the day.

“So right this second, I don’t feel any different, but the whole health approach is amazing. Changed my life,” Hitchcock said.

The VA is also trying to change lives and reduce opioid dependence with other techniques. Therapists say aquatic physical therapy is bringing results.

So is yoga.

In a large conference room, three Vietnam-era veterans sat cross-legged on rubber mats as instructor Brianna Renner—a former Marine--lead them through assorted poses.

“So welcome everybody, we’ll start by finding a comfortable seated position. Any there any areas you guys want to work on today?” Renner asked them.

“Body and mind,” came a voice from the back.

“Body and mind - that narrows it down,” Renner chuckled.

Collectively, these men have been suffering from back injuries and surgeries, depression, and arthritis. Some are taking prescribed pain pills but they would like to take fewer - or none.
Those are laudable goals, says Julie Franklin, an anesthesiologist who practices pain management at the VA Hospital.

 

A 2012 article in the Journal of American Medicine concludes that veterans of Iraq and Afghanistan with mental health diagnoses, including PTSD, were especially likely to receive opioids for pain, even though that population is also at the highest risk for abusing those drugs.

“Patients who are addicted or who have problematic opioid use need to be helped to reduce or come off medication that actually may be providing more harm than good for that patient,” Franklin said.
A 2012 article in the Journal of American Medicine concludes that veterans of Iraq and Afghanistan with mental health diagnoses, including PTSD, were especially likely to receive opioids for pain, even though that population is also at the highest risk for abusing those drugs.

At the VA Hospital, Dartmouth Hitchcock medical residents are observing the alternative therapies for possible use with civilians. They say no one sees acupuncture or yoga as overnight solutions, but they would like to see more patients give them a try.

Those who do will be tracked, so that the Hospital can determine whether alternative methods do a similar job as prescription medicines.

Read more on Eagle Acupuncture's website!

Acupuncture Helping Veterans With Traumatic Brain Injury (TBI)

The movie "The Hurt Locker," which won the Best Picture Oscar in 2008, helped portray what our veterans are being exposed to during wartime. It's easy to see, through the lens of a camera, why we see traumatic brain injury (TBI) occurring at such high rates. TBI is defined as a non-degenerative, non-congenital insult to the brain from an external mechanical force, leading to possible concussion, skull fractures, internal hemorrhage, or other internal injuries. This may result in permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.

Tony Burris, L.Ac., of  Eagle Acupuncture, treats veterans for multiple conditions

Veterans are at high-risk for TBI, and blast-related concussions because of the frequent exposure to improvised explosive devices, suicide bombers, land mines, mortar rounds, and rocket-propelled grenades. These types of injuries account for upwards of 65 percent of combat injuries, and of these, 60 percent of theses vets have symptoms of TBI. Symptoms can be mild to severe. Mild symptoms include headaches, dizziness, and fatigue, lack of concentration, irritability, sleep problems, balance issues, and ringing in the ears. More severe symptoms include being easily confused, forgetful, and troubled with constant and intense headaches. Difficulty with speech and difficulty with decision making are also common symptoms that require ongoing rehabilitation. Many of these symptoms are debilitating.

Too often, these returning veterans are unemployable, and unable to attend school for re-training. This presents a tough challenge for a young veteran who has his or her whole life ahead of them upon returning. Medical treatment often consists of rehabilitation, mental health counseling, vocational rehabilitation, and group therapy. Patients can be on a long list of medications to treat the various symptoms. Common medications are antidepressant, sleep aides, migraine medications, anti-seizure medications, and narcotics.

At the George E. Whalen Veterans Health Administration (VHA) in Salt Lake City, Utah, acupuncture is being used to provide some relief to these patients. Acupuncture has become one component of the Integrative Medicine program being offered, under the umbrella of Holistic Medicine. Patients are seen on an outpatient basis, where they are being treated for a variety of health issues, including, chronic pain, post-traumatic stress disorder and traumatic brain injury. With the use of even a few basic points, patients are reporting a decrease in the intensity of their headaches, better sleep, and an ability to cope on a daily basis.

One patient ("Jim") came to the acupuncture clinic for treatment of severe headaches and sleeplessness. Jim, a 27-year-old Iraq war vet, got caught in crossfire in 2003. A bullet entered his helmet, but did not penetrate his skull. The blast resulted in a blood clot located in the parietal area of his brain. For the first year, Jim's words were slurred and his concentration and short-term memory adversely affected. He reports developing severe, debilitating headaches, which he describes "helmet-like." He's haunted by nightmares. This combination causes him to lose a lot of time at work, which results in some depression and worry over financial issues. After staff worked with Jim over several weeks, he began to respond, reporting a decrease in his headaches, better sleep, relaxation, and an ability to cope better with his chronic pain. He was also taught to use several of the points while at home, and finds this helpful in diminishing his headaches before they get too severe.

Acupuncture will not be able to provide a cure for Veterans with TBI, but it will give them some relief when used in conjunction with other medical treatments.

SOURCE: George E. Wahlen Department of Veterans Affairs, Salt Lake City, UT