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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 [log in to unmask] -----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] >***************************************************************** ************************* >