Charlie.....

Hmmm... (thinking).... Implanting  two old transistor radios, huh?
Do ya have any particular stations you'd prefer?  <grinning>  And
if so, make sure the surgeon gets 'em right BEFORE he closes ya
up.   Better yet, ask 'em to implant the radios  with the dials on
the outside and then ya can change the stations whenever  ya
want...

Seriously, Charlie.... I'll be thinking about ya on the 18th and
wish your surgery  to bring you all the physical AND emotional
relief you desire.

With love....

Barb Mallut
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-----Original Message-----
From: Charles T. Meyer, M.D. <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Friday, May 14, 1999 8:56 AM
Subject: Re: "sham" surgeries & the placebo effect


>Phil,
>I think I may have misunderstood your initial point. One would
not expect
>new cell growth if there were no transplanted cells but
unexpected things
>do occur.  If new cells did grow as the result of "sham surgery"
it would
>be nothing short of a miracle and I would suggest that NIH or the
>Alliance fund a seed grant and hire a mystic to channel  the
spirit of an
>ancient shaman to revive the art of trephining  which involves
drilling
>holes in the skull to let out evil spirits (and believe it or not
many
>people apparently survived ).  And, maybe I will ask Dr. Penn on
Tuesday
>just to drill a few more holes and implant a 2 old transistor
radios
>instead of the stimulators.
>
>Dr Johnson's comments that PD patients are unusually sensitive to
the
>placebo effect certainly makes sense to me from my own
experience. I
>think your idea of the negative placebo effect- makes a lot of
sense and
>going from a state of hopelessness to a state of feeling that
there is
>real hope and that we have taken back some of the control that
this
>damned disease has taken away from us makes a big difference in
both what
>we are able to do and how we perceive it.
>
>As I said before however in the final analysis the value of the
procedure
>has to be evaluated on the basis of  substantial clinical
improvement (or
>slowed deterioration) compared to a placebo.  Nothing else
justifies the
>risks of that procedure. (fetal transplant) as a regular
treatment for
>PD.
>
>Thanks for the good wishes.
>
>Charlie
>
>Phil Tompkins wrote:
>
>> I have a question about why placebo surgery is done for tissue
>> transplants.  I think there is something odd about the
reasoning
>> that is supposed to justify it.
>>
>> In the 20/20 TV program on PD transplant surgery, Dr. Timothy
Johnson
>> noted that "drug studies have already proved that patients with
>> Parkinson's are very responsive to the placebo effect",
apparently
>> implying that the placebo effect is less in most other
diseases.
>>
>> It would be useful to determine precisely why this is so.
Perhaps
>> having a progressively deteriorating condition for which there
is no
>> cure is itself the source of a nocebo (negative placebo)
effect.  If
>> the baseline is negative to begin with, then of course the
placebo
>> effect would be greater.  However, this is not my main point.
>>
>> In his next sentence, Dr. Johnson indicates that the great
>> responsiveness of PWPs to the placebo effect is the reason for
the
>> placebo surgery.  "So to avoid the possibility that the
experimental
>> surgery was simply causing a placebo effect, the doctors
insisted
>> that their new study compare real surgery with implants against
fake
>> surgery with no implants."
>>
>> I do not see how Dr. Johnson's statements justify placebo
surgery for
>> tissue transplants.  The purpose of the tissue transplants is
to
>> replace those cells which are missing due to the disease, so as
to
>> re-introduce the function which the missing cells had.  The
success
>> of the surgery ought to be measured by whether or not this
purpose
>> was achieved.  Hugh Downs noted, "new cell growth has been seen
only
>> in patients who got the actual cells."  How could it be
otherwise?
>> How could one expect tissue growth from tissue which has not
been
>> implanted?  How, then, can placebo "non-transplant" surgery
indicate
>> whether or not the real transplants were successful?
>>
>> Phil Tompkins
>> Hoboken NJ
>> age 61/dx 1990
>
>--
>*****************************************************************
*************************
>
>Charles T. Meyer,  M.D.
>Middleton (Madison), Wisconsin
>[log in to unmask]
>*****************************************************************
*************************
>