Psychoneuroimmunology (PS) Applied to Otolaryngology

PS has demonstrated, with PET Scans and biochemistry, that the brain functions in the health and healing process. Objectively, studies show that after three injections of Demerol or Morphine, on the fourth injection of plain saline, patient got total pain relief. On the fi fth injection of saline, the relief was not as suffi cient. Why did the saline work? Did the brain do it? Actually, yes, the endorphin that was produced was measured! [4].

PS developed when Norman Cousins, the editor of the popular Saturday Evening Post, was dying at the UCLA hospital. The doctors had given up. His friends hung a sheet, had him watch comedies, he laughed, and he got well. He then wrote, Anatomy of An Illness, and founded the fi eld of Psychoneurimmunology: how emotions affect the body [2].
There are 2,409 references on how emotions effect immunology in Pub Med [3].
PS has demonstrated, with PET Scans and biochemistry, that the brain functions in the health and healing process.
Objectively, studies show that after three injections of Demerol or Morphine, on the fourth injection of plain saline, patient got total pain relief. On the fi fth injection of saline, the relief was not as suffi cient. Why did the saline work? Did the brain do it?
Actually, yes, the endorphin that was produced was measured! [4].

Short Communication
In PubMed there are some 127,000 articles on why placebos work. Most of these articles utilize PET Scan and other objective fi ndings to objectify that the brain in engaged.
Recent work in psychoneuroimmunology has demonstrated that stress delays wound healing. In addition, a second line of research has illustrated the adverse effects of pain on endocrine and immune function [5].
In one study of a standard orthopedic procedure, performed by several specialist in the same hospital, the Minnesota Multiphasic Test -the MMPI -predicted accurately which patients would have complications or excessive pain [6].
PS shows that the brain in engaged in healing. It may also be engaged in a negative way. When the red pill is completely effective is changed to a black pill containing exactly the same contents, the medication fails to work, fails to relieve the pain.
Hospital rooms at many hospitals have two comedy channels. Can laughing alter the immune system? PS shows that it can. Even just the act of smiling has been shown to prevent the common cold.
In every double-blind study, a percentage of the placebo patients get exactly the same result as the real pill. This can vary from study to study. It is felt that the instructions have a signifi cant effect on these outcomes.
There are 2,409 references on how emotions effect immunology in PubMed.
After reviewing these PS studies, certain practices in therapy are recommended Reduce Stress.
Explain to the patient clearly what the therapy does, in language they clearly understand. You want the brain engaged in the healing Give a set of actions to perform. When the patient follows take the red pill with 8 ounces of water before every meal, then the brain is engaged.
Most of these recommendations are made in the various therapy recommendations. For example, the Academy of Otolaryngology on Tinnitus, has guidelines that include

Applying PS to otolaryngology
Stress Reduction: There is no single stress reduction technique that must be used. Methods vary according to the physician's experience, the culture, and interest. Actions having to do with breathing are effective. Music, humor, exercise and smiling all have their advocates [8].
The method I use is counted breathing, using the mirror as a biofeedback device. Breathe in, count four, and out count six.
The exact time is not important. What is important is that the exhalation is longer than the inhalation, and be a relaxation.
Do this in front of a mirror. SEE the face relax. See the jaw relax. See the shoulders relax [9].
Counting is non-stimulatory. The anterior lobe concentrates on the numbers, instead of anxiety subjects. In stress, the breathing quickens and there are shorter breaths. Because there is longer, a relaxed exhalation, this signals the Amygdala that there is no stressor, to stop putting out stress chemistry.
I may ask the patient to do this for one minute every hour for four weeks to get them habituated to less stress physiology.
(If patient is on anti-hypertensive medication, they must be monitored as the medication dose may need to be adjusted or even discontinued.)

Visualization
PS has demonstrated that when you visualize, using all your senses, that fun day at the beach, you tend to replicate some of the chemistry you produced that fun day.
Ellen Langer, the Harvard Psychologist, put a group of 70 year olds into an artifi cial environment of ten years ago.
Newspapers, radio, television, food were all of a previous decade. In many physiologic measures, they replicated their age 60 chemistry. Her book, Counter Clockwise details the changes.
This experiment was replicated in England [10].
The better the patient understands how the therapy works, the better the brain can be engaged in the healing. For example, the antihistamine blocks the release of histamine. A picture or diagram shows this. The more the patient can visualize this fact, the more the brain can aid the healing process.

Set of actions
Take one pill with 4 ounces of water before every meal.
Rinse your nose with distilled water and the saline packet twice a day Drink hot coffee or tea before you get out of the warm bed. Otherwise, the study might have been fl awed. Gtossan Tinnitus.
My friend, Dr. Olmstead is an oncologist. Thus, he is frequently asked to evaluate new medication. As a researcher, he is useless because all his patients feel much better after visiting him [12]. honey. My patients report that this usually works. It follows the principles of PS, that humor increases immunity [2].

Conclusion
In no way am I recommending the use of placebos. But surely it is good medicine to use all the factors available to aid the patient's recovery and health.
We want our patients to get well with a minimum of medications. By applying the known established, proven methods of PS, we may signifi cantly aid their healing process by recommending Certainly, knowing that these methods have been proven to aid healing and immunology, should encourage their application [13].