Berks County Medical Society Medical Record Spring 2020 - 27

Recipients like Sgt. Meyer describe a
nearly immediate benefit from this treatment
alternative, with improvements reported within
minutes to days of the procedure.
"It feels like a million pounds is taken off
me," said Sgt. Meyer. "It's like if you took in
being downtown New York City in rush hour
traffic to all of a sudden driving down a quiet
country road with nowhere to be."
Considered a low-risk pain procedure when
administered by a trained clinician only a few
times a year, SGB was first recognized as a
treatment for PTSD in 2008. But as of 2018,
only 11 out of America's 143 VA facilities
reported using the procedure to treat PTSD.
In addition, a Veteran must first fail traditional
PTSD treatments before they can be considered
for an SGB treatment.
Ultimately, my legislation, the Treatment
and Relief through Emerging and Accessible
Therapy or (TREAT) PTSD Act, would direct
the Veterans Affairs secretary to expand access to
SGB therapy to all veterans upon their diagnosis
of PTSD by making it a covered treatment
under federal law.
While SGB is by no means a PTSD
cure-all, it is believed by many to potentially
revolutionize the way PTSD is handled. And for
many veterans who have tried it, it is seen as a
lifesaving gateway that calms their reactions so
they focus better on more traditional therapies.
"You can't ever think about fixing stuff when
you're in the heat of the fire," said Sgt. Meyer.
"(SGB) puts the fire out and allows you to really
think about what you need to do to keep the fire
from coming back."
By providing our veterans a path to
treatment access, space and breathing room they
have thus far been denied, we can provide them
a well-earned road to compassion, healing and
prosperity. And in a world that could use a little
more unity, that's a road that can bring us all
home together.
Congressman Perry is a combat veteran who
proudly serves Pennsylvania's 10th Congressional
District. He recently retired from the Pennsylvania
Army National Guard at the rank of Brigadier
General after more than 38 years of military
service. Perry is credited with flying 44 missions
and accruing nearly 200 combat flight hours of
service in Iraq for Operation Iraqi Freedom.

I thank Congressman Scott Perry for shedding light on the much too quiet
epidemic of military service related Post Traumatic Stress Disorder (PTSD)
and suicide. The rate at which our military veterans suffer / succumb
to these conditions is truly staggering. The seeming lack of new suicide
prevention / PTSD treatment options only makes this already dire situation
even more urgent.
My wife recently watched a 60 Minutes news program about stellate
ganglion block (SGB) as a way to treat military service related PTSD. After
watching that compelling news segment, she insisted that I watch that
same piece with her because the show mentioned "pain management neck
injection." As a local practicing pain management physician who offers that
straightforward procedure for various pain conditions, I too was intrigued
that such a routine pain management procedure has the potential to bring
psychological comfort to veterans struggling with PTSD.
I have since learned that several un-blinded, uncontrolled case series have
been conducted on SGB to see if this procedure is an effective PTSD
treatment option. These published studies (which the VA system has already
reviewed*) along with many compelling veteran testimonials, all appear quite
promising. Beyond that, one of those testimonials came to me through my
wife. She has a long-time friend who served in Afghanistan, struggles with
PTSD and has since followed-up with Dr. Sean Mulvaney who was featured
in the 60 Minutes news piece. Her friend has tried several SGBs. She feels
that they were useful.
As any practicing physician knows, several un-blinded case series, personal
patient testimonials and a positive 60 Minutes news piece does not
automatically equate to private insurance coverage approval. Given the dire
situation that so many military veterans are facing, however, the Veterans
Affairs secretary may be willing to overlook the lack of randomized doubleblinded studies that support the use of SGB as a viable PTSD treatment
option. Instead, by invoking the legislative process, I gather veterans could
have access to this promising treatment option sooner.
In summary: SGB is a straightforward and safe procedure. Approximately
20 service men and women commit suicide every day. PTSD often plays
a role. SGB seems to help veterans deal more effectively with PTSD. I
therefore agree with Congressman Perry that we cannot afford to wait for
more definitive studies when our veterans have already reported that SGB
helps them. Rather, it seems much more reasonable to vote "yes" on the
Treatment and Relief through Emerging and Accessible Therapy (TREAT)
PTSD Act so that veterans struggling with PTSD have better access to SGB
now as we collect more robust, randomized, controlled study data from
physicians like me who would be happy to participate in such studies. My
wife is already looking into signing me up.
Sincerely, Jason T. Bundy, MD
*Peterson K, Bourne D, Anderson J, et al. Evidence Brief: Effectiveness of Stellate
Ganglion Block for Treatment of Posttraumatic Stress Disorder (PTSD) 2017
Feb. In: VA Evidence Synthesis Program Evidence Briefs [Internet]. Washington
(DC): Department of Veterans Affairs (US); 2011-. Available from: https://
www.ncbi.nlm.nih.gov/books/NBK442253/

SPRING 2020

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https:// www.ncbi.nlm.nih.gov/books/NBK442253/ https:// www.ncbi.nlm.nih.gov/books/NBK442253/

Berks County Medical Society Medical Record Spring 2020

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