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  • #1

    The Placebo Effect

    Since I was diagnosed, I've been wondering if it would be possible to replace my Tramadol with a placebo. The goal of the Tramadol, after all, is simply to reduce my suffering - surely a sugar pill that I utterly believed in would be worth trying, right?

    Well, we accidentally did something similar. Thursday, I filled my pill tray. Discovered I'd run out of Tramadol on Monday, and told Dancer to refill my script in time. He forgot. I forgot that I'd run out. And I take soooo many tablets in the morning that I didn't notice I was taking one fewer.

    Tuesday was my first day without. By Tuesday afternoon, Anna had taken Dancer quietly aside and asked him what was wrong. I was too grumpy and irritable, wasn't willing to move much, and was showing all my objective signs of being in more-than-usual pain.

    I only noticed what had happened on Thursday. Tuesday and Wednesday I didn't feel right, but I put it down to the hives issue. It didn't seem terribly serious to me. But Dancer and Anna could definitely tell that something was wrong.

    An hour after I got the Tramadol into me, I was more active and less grumpy. I'm still not fully right, but whoa, the difference it makes.

    Well, at least we know now, right?



    Edit to add:
    Tramadol is a synthetic opiate. If I have the terminology correct, it's an opiod rather than an actual opiate. It has a similar painkilling effect, but - as far as anyone can tell - without the addiction or the tolerance problems most opiods have.
    The problem it does have is this: noone's been on it long-term yet. Or rather, I and the people like me are the first group. So noone knows yet if we're ruining our livers, kidneys, spleens, stomachs, or other useful body parts.
    Last edited by Seshat; 02-23-2012, 03:06 PM.
    Seshat's self-help guide:
    1. Would you rather be right, or get the result you want?
    2. If you're consistently getting results you don't want, change what you do.
    3. Deal with the situation you have now, however it occurred.
    4. Accept the consequences of your decisions.

    "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.
    Tags: None
  • #2
    I think that when it comes to anything going your body there's nothing wrong with trying to find something that's more suitable to you. Sometimes trial and error is the only way.

    Comment

    • #3
      The funny thing is that this is almost the only way we could have found out if a placebo would work on this problem. The trick with a placebo is that the patient has to believe that they're getting something when they're not.
      Seshat's self-help guide:
      1. Would you rather be right, or get the result you want?
      2. If you're consistently getting results you don't want, change what you do.
      3. Deal with the situation you have now, however it occurred.
      4. Accept the consequences of your decisions.

      "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

      Comment

      • #4
        The placebo effect is poorly understood. We know it works and exists. We simply don't understand how or why.

        Its inconsistency is partly why it is considered unethical to use placebos other than in a controlled randomized trial.
        They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

        Comment

        • #5
          "And when did you eat?"

          "Pizza for breakfast at ten, a bowl of chili after the lunchtime rush, six hours later I got stabbed, when the hell do I gee the god damned painkiller?"

          Her face backed away. "I'm sorry. Right now." She took a black doctor-type bag from the floor beside the bed, got out a hypo and a small stoppered vial, busied herself loading the needle. "That doesn't look like much," I complained. "What are you giving me?"

          "Well," she said, squinting judiciously at the needle as she purged it of air, "with your history I figure you've built up a heavy tolerance, so it's safe to smack you pretty hard. I wouldn't give this stuff to a civilian. You'll like it." She circled my arm with her big hand, squeezed until a vein came up.

          "A-a-l-l right!" I said feebly, looking away. I hate needles. "Thanks. What is it?"

          She slid the point home, thumbed the plunger slowly and steadily. "Fifty milligrams of laboratory-pure Placebo in a potassium chlonde/dihydroxide solution." She took out the spike and rubbed the spot with a piece of cotton.

          "Wow. Sounds good." The name rang a bell. "Isn't Placebo the Russian word for 'thank you'?" My father spoke Russian.

          She coughed loudly into her hand, and bent to put away her gear. "Yeah, it's Russian-made. Experimental. It'll come on like gangbusters in about four heartbeats."

          "I can feel it." The pain, and the body in which it resided, moved about two feet to the left of me and stayed there. I could see it pulsing vaguely in the gloom out of the corner of my eye.
          From "Callahan's Lady", by Spider Robinson

          Comment

          • #6
            Quoth Panacea View Post
            The placebo effect is poorly understood. We know it works and exists. We simply don't understand how or why.
            and then you also have the "nocebo effect" as well....
            Honestly.... the image of that in my head made me go "AWESOME!"..... and then I remembered I am terribly strange.-Red dazes

            Comment

            • #7
              Quoth Panacea View Post
              The placebo effect is poorly understood. We know it works and exists. We simply don't understand how or why.

              Its inconsistency is partly why it is considered unethical to use placebos other than in a controlled randomized trial.
              Another reason is that it's unethical to lie to patients; and placebo requires either an explicit or an indirect lie.

              The quote from 'Callahan's Lady' is .. well, none of it is quite a lie. Apparently she injects the guy with saline (well, potassium chloride instead of sodium chloride, but like saline, it's a neutral thing). She leads him to think it's something much more potent, though....
              Seshat's self-help guide:
              1. Would you rather be right, or get the result you want?
              2. If you're consistently getting results you don't want, change what you do.
              3. Deal with the situation you have now, however it occurred.
              4. Accept the consequences of your decisions.

              "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

              Comment

              • #8
                Quoth Seshat View Post
                well, potassium chloride instead of sodium chloride, but like saline, it's a neutral thing
                depends on the mix, potassium chloride is what's used for lethal injection-stops the heart.
                Honestly.... the image of that in my head made me go "AWESOME!"..... and then I remembered I am terribly strange.-Red dazes

                Comment

                • #9
                  Quoth Seshat View Post
                  The quote from 'Callahan's Lady' is .. well, none of it is quite a lie. Apparently she injects the guy with saline (well, potassium chloride instead of sodium chloride, but like saline, it's a neutral thing). She leads him to think it's something much more potent, though....
                  I'm surprised that you'd recognize the source of the quote, but not realize that the placebo was being given to a GAL.
                  Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

                  Comment

                  • #10
                    I didn't recognise the quote. Shadow attributed it.
                    Seshat's self-help guide:
                    1. Would you rather be right, or get the result you want?
                    2. If you're consistently getting results you don't want, change what you do.
                    3. Deal with the situation you have now, however it occurred.
                    4. Accept the consequences of your decisions.

                    "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

                    Comment

                    • #11
                      I've dispensed placebos in the past, on doctor's orders.

                      Our professor of biochemical pharmacology once told us (in the context of labeling requirements) that he'd seen a prescription for 5 ounces of chloral hydrate and 1 ounce of plain green syrup. Next month, the same doctor wrote for 4 ounces of chloral hydrate and 2 ounces of syrup... seems this patient had been taking it for way too long and had got hooked on it, and the doctor was trying to wean her off without her knowledge. The question was, how do you label this? If you put "chloral hydrate" when it's mostly green syrup, it's technically misbranded.

                      (Back in those days, drug names weren't even required to be on the labels unless the doctor ticked the box on the prescription that sald "Label". Controlled substances need at least the NDC number, but I have a feeling based on the professor's age that this was pre-1971, when the controlled substance act became law.)

                      Comment

                      • #12
                        Active Ingredients: Chloral Hydrate & (chemical name of the green syrup). Just hope you don't get a chemist. :P

                        Innnteresting.
                        Seshat's self-help guide:
                        1. Would you rather be right, or get the result you want?
                        2. If you're consistently getting results you don't want, change what you do.
                        3. Deal with the situation you have now, however it occurred.
                        4. Accept the consequences of your decisions.

                        "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

                        Comment

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