Tuesday, April 19, 2011

Mind Over Pain: The Future Of Surgery

Mind Over Pain: The Future of Surgery

By Danny Penman Source: Daily Mail

A beautiful sunny day in the Cotswolds, two years ago. Six paragliders are circling like eagles on powerful currents of rising air. A group of children gaze with open mouths as the giant parachutes dive and swoosh silently above their heads. Then, suddenly, something starts to go wrong. Breaking away from the group, one of the paragliders is hit by a powerful gust of wind, turning the parachute canopy inside out. The pilot starts spinning like a sycamore seed towards the earth. Though he fights desperately, he cannot regain control of his parachute.

After what seems an eternity, the young man smashes into the hillside, driving the lower part of his right leg through the knee and into his thigh. He lies face down on the ground, blood trickling from his mouth. After a moment of stunned silence, he begins screaming in agony. He knows medical help is at least 30 minutes away and that it will take another hour to reach hospital. To make matters worse, he knows that he can't afford to lose consciousness because he might never again awaken if his skull has been fractured in the fall.

Something stronger than a 'stiff upper lip' is called for. So the man slowly begins to suppress the pain of his shattered leg using a form of self-hypnosis he'd read about as a child. He begins by forcing himself to breathe slowly and deeply before imagining himself in a garden full of flowers. With a supreme effort of will, he mentally pushes the unwanted pain of his shattered knee to the back of his mind. Even though shards of bone can be seen through his jeans, he forces himself to believe that his knee is only bruised. He refuses to believe in pain.

'It is a myth,' he keeps telling himself. 'Pain does not exist.' And inch-by-inch the agony recedes before, finally, becoming isolated and distant. The hypnosis had worked. He remains in a state of calm, until finally the paramedics arrive with the blessed relief of chemical anaesthesia.

An apocryphal tale? Perhaps so. But I know this story to be all too true. I know it, because I was that young man who crashed his paraglider. And I know, from that terrible experience, that the mind has truly extraordinary powers — powers that defy logical explanation and leave most conventional doctors scratching their heads in bewilderment.

How was I, a mere amateur, able to suppress the agony of a leg and knee shattered in a dozen places, using nothing more than the power of the mind? How is it possible for hypnosis to control extreme pain? In the long months of recuperation that followed my accident, it is a mystery I pushed to the back of my mind. But earlier this month, my traumatic experience came back to me when I read the remarkable tale of Leslie Mason from Colchester. Mr Mason had two teeth and their roots removed by a dentist. Nothing unusual about that, of course. Except that he elected to have this agonising procedure performed without anaesthetic, using only the power of hypnosis to block the pain. More remarkable still, the procedure was a success. Mr Mason said afterwards: 'I didn't feel any pain.'

Teeth removed without an anaesthetic? The mere idea makes any sane person wince. Yet I knew, from my own experience on that lonely hillside, that it could indeed be possible. So I set out to discover just how such hypnosis works, and whether we have all underestimated the power of the human mind.

Hypnosis vs. Anaesthetics Talking to medical experts from around the world, I discovered that it is a rapidly expanding branch of medicine — one that many are loathe to discuss, yet which may herald extraordinary developments in surgical science. For in defiance of conventional wisdom, it turns out that dentists and surgeons across the world are increasingly turning to hypnosis as a possible alternative to general anaesthetic. They claim that hypnosis has no negative side effects, is cheaper than conventional pain relief, and — since it does not interfere with the workings of the body — the patient recovers faster, too.

To take just one example, long before Leslie Mason was undergoing his tooth extractions, Dr Mike Gow was using hypnosis to carry out surgery at his dental practice in Glasgow. Only recently, one of his patients, Amanda Maxwell, had a tooth removed and replaced with a crown using hypnosis. Four titanium screws were driven into her jawbone as part of the operation. Such an operation would normally be excruciatingly painful and would certainly need a general anaesthetic. But Amanda says that thanks to the hypnosis techniques used by Dr Gow, there was no need for drugs at all. 'I'm quite a wimp when it comes to pain,' says Amanda. 'But during the operation my mind was elsewhere so it didn't hurt. As far as I was concerned, I was walking along a beach looking at the sea. I could hear the machine drilling into my jaw but it didn't bother me at all.' So how did Dr Gow do it? He uses a standard 'light trance' form of hypnosis, which is about as far as it's possible to get from the overblown drama of a stage hypnotist. He simply asks his patients to breath slowly and deeply before imagining themselves in a beautiful, peaceful place. This could be their bedroom or a sandy beach. He then asks the patient to imagine pain as a dial running from one to ten. He tells them that they have the power to control the level of pain by simply turning down the dial in their mind.

'Dr Gow told me that if the pain rose above six then I should ask for an anaesthetic,' says Amanda. 'But it never rose above two or three during the entire operation.' The History of Mind over Pain Radical as his techniques may seem, in many ways Dr Gow is simply returning to an earlier era of medicine. Before the advent of modern anaesthetics, many Victorian surgeons explored mind control as a method of eliminating pain. In 1836 , a French physician called Jean-Victor Oudet became the first dentist to remove a tooth using ' mesmerism' as it was then known.

A few years later, Dr James Esdaile, a young Scottish surgeon, began using the same technique to dull the pain limb amputations. Yet with the discovery of potent chemical anaesthetics such as nitrous oxide and ether, such techniques drifted into obscurity. After all, given the choice, what patient would not opt for the certainty of general anaesthesia over hypnosis — a branch of science that nobody could fully explain. Yet more than 180 years on, the technique is once again being explored by reputable surgeons. One team in Belgium has operated on more than 6,000 patients using hypnosis combined with a light local anaesthetic.

The local anaesthetic is used only to deaden the surface of the skin while a scalpel slices through it. It has no effect inside the body. 'The patient is conscious throughout the whole operation,' says Professor Marie-Elisabeth Faymonville, head of the Pain Clinic at Liege University Hospital in Belgium. 'This helps the doctor and patient work together. The patient may have to move during an operation and it's simple to get them to do so if they remain conscious. We've even done a hysterectomy using the procedure.'

The idea of replacing anaesthetics with hypnosis in major surgery is now beginning to be taken seriously in Britain too. The reputable journal New Scientist recently reported the remarkable case of 46- year-old Pippa Plaisted, who had a breast cancer operation in London using hypnosis. Pippa was put into a light trance and could hear the surgeon calmly telling her the details of the operation as he carried them out. 'The surgeon was cutting and sewing inside me, but I could not feel any sensation at all,' said Pippa. 'After the operation I felt tired, but there was no nausea or wooziness. I had a clear head and felt totally normal.'

Yet despite such cases, scientists remain sceptical. Many say patients are being deliberately selected by 'pro-hypnosis' doctors for their susceptibility to hypnotism. Professor Chris French, a psychologist from Goldsmiths, University of London, says: 'Some people can cope with extraordinary amounts of pain because they can mentally remove themselves. It may have nothing to do with hypnosis. 'Most of these operations also use a local anaesthetic. Most pain receptors are in the skin, not inside the body, so the main source of pain is still being anaesthetised. Surgery also uses extremely sharp scalpels which are far less painful than ordinary knives. 'I'm not totally sceptical about hypnosis but I don't think it's as miraculous as it seems.' His hesitance is understandable. For perhaps the strangest aspect of all these procedures is that scientists are still at a loss to explain how it works.

Numerous possibilities abound. One theory holds that hypnosis subdues the ' conscious mind' and allows the hypnotist to communicate directly with the deep subconscious. In effect, the mind is switched off and can feel no pain. Another theory claims that the hypnotist is simply distracting the patient and uses the 'power of suggestion' to trick them into believing they are not in pain. Whichever theory is true, there is no doubt that hypnosis is starting to garner powerful supporters in the medical establishment. Dr Martin Wall, President of the Royal Society of Medicine's Hypnosis and Psychosomatic Medicine division, says: 'Pain is a construct conjured up by the brain. In other words, it's not real. It's simply a series of electrical impulses travelling to the brain. 'Hypnosis is a powerful technique with a great many benefits for the patient. It's a great way of relieving anxiety and boosting confidence.'

The Dark Side of Hypnosis All of which makes one wonder why it has not been more thoroughly researched. Or has it? For as with so many elements of fringe medicine, the powers of hypnosis not only have the potential to help mankind, but also to be used for nefarious ends.

Edited by: Lawyer Asad

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