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December 1, 2006
 
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HEALTH&#£. Cape hospitals consider electroconvulsive therapy Specialist hired to examine pros and cons By Bethany Gibbons news@barnstablepatriot.com Til 4. ~1 ~1_ 4-1 -QietLiusuucii tnerapy conjures images of des- perate , terrified patients strapped to gurneys pop- ping and writhing as the jui ce hits the brain. The experience was said to ren- der patients dumfounded , shuffling and mumbling like a Frankenstein without a tap-dancing routine. Over the past decade people caught in the grip of severe depression have increasingly sought relief in this once feared treatment. Numbering in the hun- dreds of thousands , these patients brave the gurney and risk general anesthesia and subsequent seizures for six months or more of relief from their symptoms. A simple outpatient pro - cedure it is not. Cape Cod Healthcare , which operates Cape Cod Hospital , has re- cently employed the servic- es of Dr. Jing Patrinostro , a psychiatrist specializing in electroconvulsive therapy, as it has been carefully re- named. While investigating the possibility of providing ECT, they face some hurdles in making this psychiatric dream a reality. "ECT is primarily a hos- pitalized procedure ,"Patri- nostro said. "We need an OR room , anesthesiology staff , inpatient and outpatient facilities, surgery consult , a cardiologist , neurologist , and other specialists. There is alot of coordination that has to take place. " Some of the specialists required to admit patients to the program are needed for pre-procedure screen- ing. As the medications used to sedate the patient carry some risks, so too does the electroconvulsive treatment , which has been noted to produce cardiac symptoms such as elevated heart rate and irregular heart beats. Patrinostro describes the patients most suited to the treatment , most of whom seem severe in com- parison to the experience of Kitty Dukakis , the wife of former Massachusetts governor Michael Duka- kis. Her recently released book , Shock: The Healin g Power of Electroconvul- sive Therapy, has gener- ated much publicity for the treatment. "Patients with acute de- pression , especially with psychosis resultingin delu- sions and hallucinations , are good candidates for ECT," Patrinostro said. Also the patients suffering from acute mania will be considered for ECT right away. In these cases the goal is to get the patients under control as soon as possible. Schizophrenics suffering from delusions and agitation are good candidates. "We also treat patients with Parkinson 's disease who are dealing with both motor impairment and psychosis. Another group is pregnant women , for whom treatment with a lot of medications can be ex- tremely risky. ECT is safer for the fetus than treatment with medications." Patients like Kitty Du- kakis who have had little success with traditional medications used to treat depression , are also in the ranks of those for whom treatment might be rec- ommended. "If they have gone through two failed medication trials , they are candidates ," Patrinostro said. "Especially when they are not eating, not sleep- ing, starving themselves to death." As it is categorized as a life-saving procedure - Medicare andMassHealth often payforit - ECT isusu- ally administered in aseries of six to 12 treatments. While some institutions offer outpatient procedures to minimize the expense , the more common route in Massachusetts is to be admitted to an inpatient psychiatric facility, given a full evaluation and then begin the thrice-weekly treatments , resulting in an average three-week hospi- tal stay. Patrinostro says that researchers , scientists and doctors are still learning about ECT. "We don't know why exactly it works ," the doctor said. "A lot of study has been done to discover the mechanism by which the treatment works on the brain. Because we don't know how it works , it is hard to limit side effects. " Great concern and cu- riosity has been raised by the memory loss caused by ECT. Patrino stro says that memory loss is a known side effect of the treatment. "There is short-term memory loss from the few days or weeks before treat- ment to several months af- ter treatment. The residual memory deficit is about six months, but most people regain their short-term memory after this period ," she said. "Most of my pa- tients report drowsiness , headache and soreness immediately after ECT. Older people especially experience confusion and memory loss. Most patients that I have seen, admin- istering this treatment in Iowa for four years, did not complain of long-term memory loss." Within six months of treatment , 50 percent of patients experience recur- rence of the depression or underlying mental illness. For this reason , anti-de- pressants or other medica- tions are usually prescribed for maintenance. "We are trying to provide as many services to Cape residents as possible ," Pa- trinostro said. "Because of the complexities of the program ,we are not certain when , or if, ECT will be administered here , but we are working on it." Start now to prevent winter blahs Try vitamins, exercise, or even an act of faith By Bethany Gibbons news@barnstablepatriot.com New Year's resolutions al- ways seem to come too late. The pies have all been eaten, the eggnog and champagne downed, and the inactivity of winterhasdoneitspsychologi- cal damage. Getting into the gym and starting a diet might helpto getadate byValentine's Day,orintoaswimsuitbyJune, but those goals are trivial for those who struggle to simply function. The weather is mild and fall seemsto havehalteditsinexo- rablemarchtoward winter.For sufferers of winter depression, clinically known as seasonal affective disorder, the warm temperatures may not help to slowthe progressionofthat dis- order.Whether oneisguarding against more serious depres- sion or simply trying to avoid acase of the winterblahs,now is the time to focus on healthy activitiesthat elevatethe spirit and keep the blues at bay. Clinicalnutritionist Fred Al- lenisone ofanincreasingnum- ber ofphysicians,nutritionists, and chiropractorswhostrongly advocate using vitamin D to alleviate or prevent seasonal affectivedisorder.Produced by theskininresponsetoultravio- let radiation, vitamin D from the sun is generally not suffi- cient in northern latitudes. "We've tested hundreds and hundreds of people to look for vitamin D levels in the blood, and one hundred percent of our patients show levels that are too low," said Allen. "Most of the results show levels that are below the low end of the normalrangeandsomeshowed levels at the bottom of the normal range." Allen explained that, in ad- dition to our unfortunate po- sition north of the equator, many people earnestly avoid exposure to the sun. "Most people are deathly afraid of going in the sun, and when they do they use heavy amounts of sun block and don't stay out for long," he said. "While skin cancer is a risk from sun exposure, stud- ieshave shown that vitaminD alsoreducestheriskofprostate cancer,breast cancer,osteopo- rosis and other diseases." Using supplements is a sim- ple way to increase the levels of this powerful vitaminin the blood, while also saving the skin. "It takes a while to get backtonormallevels,butitwill work and also increase bone density and bone marrow," said Allen. When looking for a supple- ment, a high amount of the vitamin is generally recom- mended. "The body produces a tremendous amount of the vitaminifyouareoutsideinthe suninthe summer,"Allen said. Therisk oftoxicityisminimalif consumed according to direc- tionsand abetter wintermood may well be the reward. Allenalsorecommendsvita- min B complex, citing studies that showincreasedwell-being andsomeeffectivenessincom- bating winter depression. Mental health professionals frequently prescribe physical activityasatooltoprevent and minimizedepression.Add that to ahealthydiet andnutritional supplements and a good start hasbeenmadeto prevent some ofthe pitfalls ofthe longwinter months. Tricia Michallyszyn , vice president of development for theYMCA of Cape Cod,boasts of the psychically invigorat- ing nature of their program. "Cardiovascular activity has been proven to be one of the most effective ways to treat seasonal affective disorder. Our members stay fit, feel good and, more importantly, socialize," she said. "People become isolated in the winter and the club becomes a home base, providing a very social andinteractivefamily.Wereally know our members andit gives them that sense of belonging that they may be lacking in their lives." Openingat 5:30a.m.andnot closingitsdoorsuntil9atnight, the Y, as it is affectionately known,hasmuchtoofferseven days aweek.From pool activi- ties to ballroom dancing, and alltheweightliftingandPilates in between, the Y is a good example ofthe manyresources available to local residents. Getting out for regular walks willprovide the recommended cardio, but staying motivated without the social component maybe difficult for people who suffer from depression. There are other pursuitsthat helptoprevent depression.What wasonlastyear'sresolutionlist? Learning another language or picking up a new hobby? Keeping the mind active can be a useful tool to offset winter sluggishness. Adult education programsandclassesatthelocal communitycollegearejust some oftheintellectuallystimulating options available. Faith-based endeavors,suchasjoiningcom- munity shabbat dinner at the Cape Cod Synagogue or the women's guild luncheon at St. FrancisXavier inHyannis,offer meaningful social experiences. Minimizingaddictive behaviors duringatime ofyearthat serves upplentifulemotional"triggers" is also important in preventing depression this season. The Cape's #1 Location For Gas Logs JSSMM *-* sisr.t im 1 1 Showroom Available with At Hall Oil Natural and *4|«fc.*»stoffciM 0pe " Propane Gas : \i Mon. - Fri. FREE Estimates WmWf 9:00 - 4:30 , Sat. I - _^_ „, „ , . 9:00-11:30 v ¦•-^:~«s^'^'i """¦»¦"**i WII -^'trs"""""."™' ' " ' I . . . . 1 • 1 :.^» " .t,l! ,l,il<^ | |^ ; j|i ^iT^ ^ t-. jg^|)j t » I .I l.« M UlUUi ? I*****— -^..^ ^ s:iMWt&> *m&& *»*°>-» *mutm, i .«JP tagBm *9m, *m^ m w^^ m m\ w^^ m ' m r m—^~TQa^m; * « > i -v mr i t m 1 »-' ~* - • — --M ": ».\JL7 j », ^*^iv LMW LL^&^ V , 9 *^> & - mM miL. >3t ' JM . 4k•' 508-J98-3831 ^ ^ /'Toll Free 866-398-3831 ^^^^^^^^ t |^BReaKaway 435 Ri I H. P.O. Box 140 1. S. Dennis , Next to Mid ( ape Home ( enter Eye Exams • Consultations • Second Opinions A.WJSS,IID. Eye Care For: Cataracts • Glaucoma • Retina • Cornea u^m**. Macular Degeneration • Lid Plastic Surgery rorA«l M ,M.o. Diabetic Disease • Laser Surgery • LASIK Surgery MARK P.HATTON,M.D. JEFFREYS.HEtER,M.O. JL' ^ ^ ^A ^ m \ \ \ \ ^ L^ mm\ \ mmm^ ^ j£ . MARK S HUGHES. MD WWW IFor over 15 years Ophthalmic JAMES W< HUNG< M<°< mHH Mm r, L B.THOMAS HUTCHINSON,M.D. M l jyf i l i J l i M l I f 1 Consultants of Boston has been Wkmm aA ¦ SISK I ^r 'n9 in 9 Boston s top Board MICHAELG MORLEY MD 1 H M M ¦ ¦ B Certified Ophthalmologists to MICHAELF OATS,M.D. ICape Cod. They come to the WILLJ.PRICEM.O. ICape to see you so you do not MICHAEL B.RAIZMAN,M.D. ¦fr^^^^^^^^^^^^Uneed t0 make the tr|Pt0 Bos,on- CLAUDIAU-RICHTERiMD - LOCATIONS ALSO IN BEVERLY, IWe welcome new patients, DELIAN.SANG,H.D. BOSTON, BROOKLINE, Iplease call for an appointment. BWDFOR°J SH|»WLETON ,»I .D. STONEHAM AND WALTHAM JOHNV.THOMAS,*D. TREXLERM.TOPPING,M.D. . 1 1 ... ffi?T—MM^^^^^^^^^^^^^^^^^ M ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ OpNlh^i^^ n^jlunti ol Boilor, Auction to benefit SIDS research The Paige Victoria Perry Trust Fund and Perry Family will hold a fund-raising auction tonight at 6 p.m. at the Sandwich Glass Museum. Paige Victoria Perry passed away this year at 48 days of age due to Sudden Infant Death Syndrome (SIDS). SIDS is the sudden death of an infant under one year of age that remains un- explained after a thorough case investigation. The goals of the Paige Victoria Perry Trust Fund are to educate people about SIDS; support re- search related to the cause and prevention of SIDS; financially assist parents and to memorialize Paige Victoria Perry. Along with the auction to raise funds, Mary McClain for Massa- chusetts Center from the Sudden Infant Death Syndrome will be speaking on the latest develop- ments concerning SIDS and the services providedvia the Center at Children's Hospital in Boston. Donations to the Paige Victoria Perry Trust Fund will be accepted at the door or may be mailed to Post Office Box 1435 , Sandwich, MA 02563. Flu clinic offered The Town of Barnstable is offering a flu/pneumonia immu- nization clinic from 10 a.m. to 1 p.m. on Thursday, Dec. 14 at the St. George Community Center on Route 28 in Centerville. There is a nominal charge of $3; those un- able to pay will not be charged. Drive-in service is available to handicapped people at the side of the building.These immunizations are recommended for those 50 and older or those with chronic illnesses. No children under 13 will be accepted at these clinics. For information, call 508-862-4644. Grief support group offers help The Grief Support Center of Hospice & Palliative Care of Cape Cod is offering "Coping with Loss Through the Holidays" on Monday, Dec. 4 from 4:30 to 6 p.m. at the Gus Canty Community Center at 790 Main St., Falmouth. There will also be a session held in Hyannis on the same day, from 2 to 4 p.m., at the new offices of Hospice & Palliative Care of Cape Cod, 765 Attucks Lane (between the Barnstable Health Club and the Women 's Workout Center). The session is open to anyone dealing with the death of a loved one or friend. The group will be led by licensed clinicians. The fee for this session is $10, with a sliding scale available. To register, or for additional infor- mation, call the Grief Support Center at 508-957-0427 or 1- 800-642-2423. AEDs now required in health clubs The American Heart Association commends the state Legislature for passing Kayla's Bill,legislation that will expand the Massachu- setts' Public Access to Defibril- lation program by requiring all health clubs and fitness centers in the Bay State to be equipped with an automated external de- fibrillator (AED). The bill, initially sponsored by Sen, Rob O'Leary was named after Kayla Richards, avibrant,healthy 22-year-old who collapsed and subsequently died in March while exercising at a gym in Plymouth. The gym did not have an AED at the time of her collapse. Each year, more than 950,000 Americans diefrom cardiovascular disease, making it the number one cause of death in the United States. Approximately 250,000 people die each year from sudden cardiac arrest - more than 600 a day. Defibrillation is the only known therapy. The technique of delivering electrical shock to the heart can restore the heart's normal rhythm, but it must be done within minutes of the arrest. Help for panic and anxiety Judy Schiffman,director of Pain Relief, Inc., presents a pain and anxiety program, "Overcoming Fears, Anxiety and Agoraphobia; Achieving Control, Positive Self- imageand Constructive Thinking," Mondays from noon to 1 p.m. and Wednesdays from 6:30 to 7:30 p.m. Call 732-940-9658. Work it off The Young at Heart/PACE ex- ercise program, a combination of weight training, aerobic,endurance and flexibility exercises, is held through the VNA and the Mas- sachusetts Chapter of the Arthritis Foundations at community sites across the Cape. Eachsession runs for 10 weeks. Call 877-267-7700. DVD helps children who stutter A new DVD starring children who stutter is available at the Centerville Public Library and the West Dennis Library. The video is aimed at acquainting children who stutter with others who also stutter and are handling the challenges. Daily Christian recovery group The Christian Recovery Fel- lowship holds a daily meeting on Monday from 7:30 to 8:30 a.m. at the Salvation Army Worship and Services Center on North Street in Hyannis. The open-discussion, Christ-based meeting is designed to provide a safe, confidential environment forthose "searching, struggling with alcohol, drugs, hurts, habits, shortcomings or hang-ups of all kinds." Meetings are open to all and free of charge. The group has been meeting since 2002. Contact Charlie Markari- an at 508-775-5733 , or e-mail charlie5733@hotmail.com. Asthma support group Dr. Paul Sklarew leads an asthma support group at the Allergy and Asthma Center of Cape Cod, 244 Willow St. in Yarmouthport. Meetings are every fourth Wednesday in October and December. Call 508-362-0099. . HEALTHREPORT