the 'miraculous' ptsd treatment that is changing lives
8 minute read
cory taylor, seen here with his service dog cueinn - a six-year-old sheepadoodle - outside of his casselman home, is much happier these days. the retired military investigator got ptsd after serving in afghanistan, leaving him struggling to even string sentences together, until he learned about a treatment used on u.s. veterans.
postmedia
cory taylor was desperate for relief. his issue wasn’t physical, but psychological pain.
and then he walked into the pain clinic at the ottawa hospital’s general campus in the summer of 2020.
he had been struggling with post-traumatic stress since serving in afghanistan with the canadian forces national investigation service military beginning in 2012. on his first day in kabul, a crowd gathered near his vehicle. he was in the passenger seat. then a bullet hit the window directly beside taylor’s head.
the ballistic glass protected him from physical injury, but it set the stage for his time abroad. each subsequent incident, including ambushes, left him with serious psychological damage.
taylor worked in the military for two more years after returning to canada, but he had to retire in 2015 when he had a severe relapse.
during a low point, he experienced a dissociative episode in which he couldn’t understand what people around him were saying and was unable to move without help.
“it was a very terrifying experience,” he said.
by 2020, his life was ruled by ptsd, which left him on a knife’s edge — irritable, jumpy, trouble sleeping, at times immobilized by stress. he was unable to do many simple things. driving, in particular, was a trigger. he used a service dog and his wife became his full-time caregiver.
advertisement
the 40-year-old married father of young teens was receiving psychological counselling, but it hadn’t given him back the peace of mind, and the life, he had lost to ptsd. his appointment at the ottawa hospital’s pain clinic in july 2020 came about because he desperately wanted help.
“my whole being was trying to get healthy for my family,” he said. “i didn’t want to be a burden. i was looking for any way i could do that.”
and then he heard a podcast about a simple treatment that was being hailed as a game-changer for some u.s. veterans and others who were crippled by ptsd. while not a cure, it could relieve some symptoms within minutes according to reports and a growing body of research.
he was intrigued.
the procedure, called stellate ganglion block (sgb) involves injecting local anesthetic into a cluster of nerve cell bodies near the base of the neck. the thin needle that injects the anesthetic is guided by ultrasound. although not approved for treatment of ptsd in canada, the exact procedure is routinely performed in hospitals across the country to treat complex nerve pain.
taylor, who had been an investigator with the military police, set about learning everything he could about the procedure and its use to treat symptoms of ptsd. it has been around for decades and has been used widely in the u.s. to treat veterans for around ten years.
advertisement
he asked dr. rebecca gomez, his psychiatrist at the operational stress injury clinic located at the royal, whether she had heard about the treatment’s use to treat ptsd symptoms. she hadn’t, but wanted to learn more.
taylor put together an information sheet for gomez and her colleagues. two weeks later, gomez called to say dr. dan james, the medical director of the pain clinic at the ottawa hospital, had agreed to perform sgb on taylor as part of a research study.
it was a procedure james had performed frequently on patients with complex regional pain syndrome affecting their arms. he’d heard about the use of sgb to treat the symptoms of ptsd and was eager to learn more about it.
“the stars sort of aligned and the timing was quite perfect,” he said.
taylor couldn’t believe the unexpected speed at which things moved. the day of the procedure was mere weeks from he first reached out to gomez about the treatment.
the procedure took less than 15 minutes. for taylor, the change was almost immediate.
“it was like the volume on the world had been turned down. i had been listening to white noise for years and the white noise was gone,” he said, recalling that moment. “it was this weird sense of peace.”
advertisement
gomez was there that day to watch and learn, and she could see physical changes in taylor almost immediately.
“he was more relaxed and he was smiling,” she said. “we were wearing masks but you can tell.”
and when taylor stepped outside the hospital for the drive home, “it was like i was stepping for the first time back into canada,” he recalled. “the world wasn’t out to get you.”
he enjoyed the drive back to casselman, east of ottawa, for the first time in almost a decade.
as soon as he got home, he jumped into the pool to play with his kids.
***
dr. rebecca gomez is involved with the trial of a ‘miracle’ treatment for ptsd called stellate ganglian block.
jean levac
/
postmedia
the use of the stellate ganglion block procedure to treat ptsd has been widely studied, but researchers are not entirely sure why it works.
the local anesthesia is injected into the structures which provide most of the sympathetic nerve signals to the head, neck, arms and part of the upper chest. the drug wears off after a few hours. and yet the dampening effect on ptsd symptoms can last for months.
doctors know they have hit the target when the patient displays signs of something called horner syndrome, which can cause a patient’s face to droop on one side, among other things.
on the day of his procedure, taylor recalls james withdrawing the needle from his neck, stepping back and confirming that he had signs of horner syndrome. those symptoms lasted about five or six hours.
advertisement
gomez said a theory about the treatment is that the local anesthetic acts as a reset button by temporarily blocking nerves that travel from the stellate ganglion to parts of the brain that are more active in ptsd, decreasing the release of stress hormones like norepinephrine or adrenaline.
the stellate ganglion is part of the sympathetic nervous system that affects a person’s fight or flight response. some describe ptsd as a syndrome in which the fight or flight nervous system gets stuck in the on position. using that analogy, sgb acts like an off switch that resets that response.
before the procedure, taylor said his stress level was regularly nine out of 10 as soon as he would wake up in the morning—and it’d only get worse from there. after the procedure, he would wake up with a stress level of zero.
“it felt miraculous.”
gomez, meanwhile, wanted to see the long-term impact of the procedure. taylor became the first of 10 patients in a case study.
a total of almost 30 patients received the procedure, but gomez said the researchers received complete survey results from 10. that study showed a significant decrease in symptoms such as sleep disturbances, intrusive thoughts and flashbacks. patients also reported a significant decrease in symptoms of depression.
advertisement
gomez and her colleagues from the operational stress injury clinic, the university of ottawa institute for mental health research and the royal, won an award for that case study on sgb. a randomized control trial with the ottawa hospital will soon be underway, involving 54 former members of the military and the rcmp who have ptsd. taylor is part of the research team.
they are only recruiting members of the rcmp and veterans right now, but researchers are hoping studies will soon include active members of the military and first responders.
dr. dan james, he is medical director of the ottawa hospital pain clinic and part of the upcoming research trial into this procedure — stellate ganglion block.
jean levac
/
postmedia
***
ptsd is often associated with the military and first responders, but it affects a broad segment of society.
according to statistics canada’s 2021 survey on mental health and stressful events, about eight per cent of canadians experience symptoms of ptsd, which can include unwanted thoughts or dreams of the traumatic experience, strong physical reactions when reminded of the event, strong negative emotions, and a loss of interest in doing things they once enjoyed. about five per cent of them have had ptsd diagnosed by a professional.
the prevalence of ptsd in the military is higher than in the general public — 13 per cent among regular force veterans released from service, according to a 2013 survey.
advertisement
ptsd is also more common among women than men. one in ten canadian women have symptoms of ptsd, compared to eight per cent of men. sexual assault was commonly reported as the worst event faced by canadians exposed to at least one potentially traumatic event during their lives.
crucially, 82 per cent of people who tried to get help faced difficulties.
gomez said she is excited about the possibility of eventually seeing the treatment be made available to a broader group of people who suffer from ptsd, especially those who may have a more difficult time accessing treatment. that includes refugees and survivors of violence and assault.
for members of the military and first responders, ptsd is an occupational injury and treatment is mandated. but for many people in the community, treatment is inaccessible, gomez said.
“when i see a procedure like this, i almost consider it a no-brainer to make it accessible to other people,” she added. “it doesn’t involve any extra training and is already done in pain clinics. if we can make this accessible, it would be very beneficial.”
the low cost of the procedure is a factor that makes gomez optimistic the treatment could eventually become more broadly available. the anesthetic used in the procedure — bupivacaine — costs about $18 per injection.
advertisement
but not every patient has profound results—especially not the level of taylor.
out of nine patients who undergo sgb, according to gomez, about three will see a significant improvement. three or four will have some benefit, but not as significant. around two will have no noticeable benefit. still, up to 80 per cent of patients report a 50 per cent reduction in symptoms.
in the upcoming study, some patients will undergo the procedure once and others will have it a second time a few weeks later. there is some evidence, said gomez, that having it twice provides more benefits.
***
cory taylor has now had the procedure three times — around one year apart.
the treatment has allowed him to do things he once could not have dreamed of doing — driving his kids to swim practice in cornwall, becoming a service dog trainer and planning a vacation with his family.
it has allowed him to apply what he has learned through counselling and therapy to help himself.
“it is not a cure,” he said. “it alleviates the most debilitating symptoms and allows you to use the skills you learned to deal with your ptsd.”
the combination has changed every aspect of taylor’s life. his wife tells him she has her husband back.
taylor has become an evangelist for the treatment, especially when he meets other veterans as part of his service dog training.
advertisement
“the world needs to know about this,” he said. “this could save careers, marriages and lives.”
editor’s note: our team is committed to telling longform stories you can’t find anywhere else. read more of our latest features and investigations here. help us untangle the next great yarn by becoming a subscriber: ottawacitizen.com/subscribe/
share story
