Host dr carsten lake who taught. There a lot of side effects and here i already feel them still make a. Many effects and many side effects of medications are caused by the placebo effect what this is all about this is what im going to talk to this doctor here one is laughter two im here in berlin at the school of psychology welcome to check. The placebo effect shows us that psychological factors and important component for difficulty of medical treatment and word placebo means i will please so its a promise in medical terms we call a placebo or a medication that doesnt contain any active ingredients especially in pain treatment we know that placebos do work at the patients have to believe in them. Knows a lot about pain his ordeal started after a hernia operation it was the beginning of a medical odyssey. Paid for by about the pain started a week after the surgery and he got more intense probably worse and worse with pain in the lower body that i could barely stand it i visited loads of doctors hoping to find a solution but they couldnt find anything i took more and more painkillers which led to me withdrawing even at home that in the end i was spending all my time at home so thats all i have to say afterwards i knew the t. V. Programming by heart and i had this fancy book. The manager had to quit his job he was incapacitated the pain completely took over his life. Then he was given the chance to take part in a study he was told that research was being done on your feedback a special kind of Pain Management therapy for him it was a real medical treatment that gave him hope. Really concentrated on looking at the circle to see if i could somehow influence this through certain breathing techniques or visual focus techniques so i was really deeply into it as it. Didnt realise was that the experimenters were just pretending that he was controlling his brain activity in actual fact his brain was not linked up with the computer at all. And the video was being played on the monitor it was a placebo a fake therapy. And i had the feeling a hundred fifty percent that i was influencing the image through my movement my breathing technique my gaze. And the treatment worked later the ruse was revealed to him. A successful example of the placebo effect which may play a role in all medical therapies the power of expectation has been especially well researched in the area of Pain Management. Placebos activate the same neurotransmitters in the brain to release by real pain medications that means the placebo effect is real. Its likely that expectation plays a crucial role and that was also a decisive factor in our experiment that is as weve built up the expectation that this form of treatment would work and this disease of the hundreds from vote vote whats astonishing is that havel birches pains have largely subsided even though he knows that he underwent a fake treatment that. Persuaded me that only you can change your situation. And if an experiment like this worked then you could take other things into your own hands and purely with your own mind you managed to get away from the pain because you became more active exercise a healthier diet and above all he started going out and meeting up with friends once again. Vinnie the more i did the less pain i heard. On a pain scale of one to twelve i was at eleven. These and today after several months of gone by id say im now at level one. Its almost gone. Down to see both x. Can only work if patients believe there is even a Pain Medicine that only then will they have any chance at all of experiencing self efficacy or the placebo effect as we call it in to the notes. But in every day medicine this wisdom is often not applied. Medicines or. Right without comment pills are simply handed out in the hospital and before an operation risks and side effects a move frequently emphasized that their desired outcome it all boils down to positive expectation. With them a medical therapies healing effect is far more potent than without. And you have to school of psychology in berlin meeting talk to one hundred fatah thanks for having me today using Scientific Research with placebos in to do it in a quite different we so what did you do what we did we took patients undergoing card and so very and we invited to a short psychological intervention where we targeted expectations realistic positive way and we compared that to patients that underwent a stellar procedure so what did you do did you just say oh you before you get over it you know so what we did is to target the last expectations we wanted to talk about things that matter to time in their everyday life and then we set up a personalized expectation plan. That would show the cause after surgery like four six weeks after surgery three months after surgery six months of surgery which activities that are important to them are realistic that they could regain and then we put it in imagination exercise and thinking about six months after the surgery everything went well where are you going to be what are you feeling what can you do and this actually works yes so im going to tell you about one example we had. A woman who before her cardiac disease was very active she was going on vacation in mountain c. Area in italy and she would like she really laughed wondering around back up the mountain and she wasnt able to do that anymore because of a carving disease. So we explained to her that its really realistic that after surgery she was going to be physically able to do this again and then we imagined. How she was spect six months after surgery and running up the hill or walking feeling the sun and feeling the draw you back did she do the mountaineering after that yeah thats thats a really nice anecdote so actually three months after surgery i got a postcard from the comal and its any where she wrote me that she has been walking up and down the hills for this is well yeah could i use that as a g. P. In my practice exactly and you definitely should do that so what i would recommend is that you talk to the patient get a feeling of how he understands to go over this and the treatment that youre going to advise to him tell him where and when hes going to acknowledge or actually going to experience the improvement of the treatment and i would advise you to build a good practitioner patient relationship being in tactic. Giving sentences of good expectation and hope doesnt mean i could even use some sugar pills with no active ingredients in it to get some through pubic results so actually theres a lot of Research Showing that a lot of the general practitioner is giving placebos in some sort of way but just giving a sugar pill and telling your patients Something Else is unethical. So we can use this in Placebo Research but its unethical in clinical practice fortunately at least Placebo Research is beginning to find results about open Placebo Research which is you tell the patient im giving you a placebo theres no medication in it somehow know that it works. And its. Probably going to help you and its the worst so do your research is still in its infancy but theres already the first studies that show that even those patients with an opus evo can prove theres also an evil twin to the placebo called no simple hand seeing the side effects of medication and this is one of the reasons some of my patients throw away their pills. Patient for always told to carefully read medicine information leaflets but is it really necessary due to his age seventy three usually heed the advice. Side effects can be really dangerous for example. Good information. But protect patients. Since the late one nine hundred seventeen. Explain to patients about the benefits of a given drug every single potential fight effect. Shows that ninety percent of people surveyed believe the medicines information leaflet is important. Information makes twenty nine percent of those surveyed feel anxious if people over age sixty its thirty seven percent. Of scientific. Medicine can have side effects. Simply because people expect them to many studies have been conducted on this very question. Being divided into groups receiving real medicine or. On average one in four complaints of side effect even if people in the Placebo Group given the medicine. Mean that you can feel side effects just because he would expect to. Take for example the control. Even the. Complaint of. The participants was mention what could happen. And its very clearly evident that side effects of both groups. Clear that just. Leads to the. Treatment. Perhaps. As. Await this information leaflet from my patients because they have all those side effects on it and patients get but im not allowed to do this so how can i listen and worries of my patients i would recommend is to engage in an open discussion with the patient ask her or him what did she understand about the leaflet she has a specific concerns and then you should take your knowledge as a doctor and your experience as a doctor to set those side effects in a bigger context you can tell her like well there understocked are meant for legal reasons but in all my years of practice i never notice anybody having decided that and then of course we should outline the benefits of the medication. That usually are bigger than the side effects but we just saw in the report that patients who were taking placebos also had no cebu effect that they got side effects even theres no effect at all in the sugar pill so it doesnt mean if i read this awfully long information leaflet here and they say it may produce some coughing does it mean i just will start coughing because i just read it well one explanation is that we all have sometimes even we are not sick once we have a headache once we have a better. The information leaflet automated medication puts that into a different context so if you read on and leaflets that this medication can produce a headache. You focus on the headache and then you set it into the context of the make medication you think ok the medication is bad and which may lead to not taking the pill were supposed to which will tampa your benefit of the medication is that you pm always convinced that the medication i prescribe to my patients will work and i always weigh the side effects against the good effects so how can i transfer this knowledge to my patients well i think its easy to just break it down in a common sense language. And tell about the benefits that outweigh the potential side effects and other any words or phrases i should. Using in my talk to my patient does some research already that indicates that if you say eighty percent of my patients not getting side effects does produce less no see both fact and if you say twenty percent will get side effect and we could have you question from dick newton from florida in the u. S. And hed like to know whether its wrong to be critical towards adverse effects because i mean in the end cases patients are hurt by medications no absolutely not thats not wrong because as a patient you should be well informed to make sometimes a really important especially undergo this treatment that has potential side effects. And well especially if the side effects. Dramatic you need to have the information to weigh all those things but then we should enter into a discussion with a doctor which has medical knowledge which has experience and might help you make that decision or you read thanks so much for this great talk thank you and this is the point usually in this show i tell you to write as an email if you do have any questions but let me put this in a more positive way today if you want us to answer any questions please write us an email. Coming sure well be looking at the cycle sematic disorders emotional problems can often be behind physical conditions why and what help is available if you have questions about that send an email to in good shape but d. W. Dot com writes psychosomatic medicine in the subject line we look forward to hearing from you. How does this week reposition work again many of us dont. No because the first eight calls is ages back but theres one thing for sure if you dont help in an emergency its the worst thing you could do. By the time the ambulance arrives it can often be too late for someone whos been injured even bystanders who had First Aid Training often feel helpless in a medical crisis. The participants in this course have been sent here by their company to learn best first aid practices. So what measures can anyone take in an emergency situation. After a Traffic Accident the first thing to do is flag the site to warn following drivers then call Emergency Services. If the injured person is unconscious only move them out of the car if theyre in immediate danger take care not to aggravate any potential spinal injury if theyre unresponsive check whether theyre breathing if they are get help if possible to roll them onto their side in the socalled recovery position without twisting them the chin should be stretched and the mouth down so the airways remain open and the person can choke on their tongue. And in the recovery position a patient sometimes vomits the head should be as low as possible so the vomit can drain from the mouth. If the person is not breathing begin cardiopulmonary resuscitation or c. P. R. The lower third of the breast bone should be compressed downwards using your hands and outstretched arms at a rapid rate of one hundred to one hundred twenty compressions a minute the aim is to keep partially oxygenated blood flowing through the body especially to the brain to mouth to mouth breaths can be given every thirty compressions but keep the compressions going until professional help arrives if a defibrillator is available how do you operate it. An automated external defibrillator can restore the hearts normal rhythm place the adhesive pads on the persons chest as indicated the defibrillator analyzes whether an electric shock is needed. You cant do anything wrong because the defibrillator automatically analyzes the hots rhythm and if a diagnosis cardiac arrhythmia a ventricular fibrillation it administers the shock. Many would be helpers are scared of making potentially fatal mistakes what can go wrong during first aid very little apart from maybe doing nothing a lot of highway telephones also connect to Emergency Centers that offer basic instructions telling a First Responder what to do that encourages more people who witness accidents to get actively involved. In germany at least no one need fear legal repercussions if they harm someone while giving first aid. During the battle if you makea casualties condition worse while administering first aid you cant be held legally responsible if you responded with reasonable care according to the best of your knowledge within underspent a for the victim to survive even with say a further spinal injury and at least theyre alive. The overarching need is to keep the injured person alive until the Emergency Services get there. Many people have a slightly sideways curve spine and this is not a problem but if theyve got a severely deformed back its a disease called scoliosis and this is painful and restricts their motion one solution can be a custom made brace on operation but this is a major operation and the only performed by experienced surgeons. This is how his son to have agonised back looked until recently a week later she began a new life enabled by an operation that was preceded by a new x. Ray technique this Technology Made it possible to measure the twelve year old spine more precisely. Due to the severity of the disorder her family turned to the spine experts at the hospital in berlin left untreated scoliosis can lead to health problems. My liver is this is normally a very common disorder about one in every fifty girls has it but usually to a much lesser degree. Shell still grow during puberty theres another growth spurt but then shell not grow taller instead shell grow into this socalled deformity thats why surgery would be highly recommended here even though shes only twelve waiting will not help as the curvature will only get worse. To prepare for the operation experts news a new imaging tool a vertical scan or. Its a whole body x. Ray machine that scans the entire back while the patient is standing. Humans on the is concerned are we now have a three dimensional image of her spine but it also shows the connections to her pelvis and hip joints and her families and that helps us determine exactly which profile we need to set using the screw implants. The scan x. Rays cassandras body layer by layer using a much lower radiation level than the ordinary procedures thanks to the vertical images the positions of the screws can be determined much more precisely. And then pairs of pedicle screws will be anchored into the spine. Which will then be connected to one another over one or two rods on the right and left. But none of her bones and the. One we can on the operation is proving a success because sandra has been on her feet again for three days now. A new image taken with a vertical scan it shows what a success the operation has been. Shape of has spine has been almost completely straight using a total of twenty screws. The curvature went from ninety degrees to only twenty two degrees. And so theres a can you recognize this this was your spine before and this is it now its almost straight or yeah do you notice it too its grown a bit taller i hope you feel good. Shes growing five point five centimeters taller thanks to be operation and kissinger nights how it feels. To stand for well at first i stood in front of the mirror and saw from the side what my back looks like now and i was actually speechless because the whole bulge was now gone. And now theres just a small bit. Of all have the screw implants in her back for the rest of her life but thats a small price to pay. Thats it first day next week and until then lets all try to say in good shape. Buying dortmund shall go like say go for your favorite teams weve got all the best goals weve got all the action dont miss no one has to go right here. To help you is the whole german football shared experience every match against the books. Youre a mess. Highlights. Following in casanovas footsteps of. Musical instruments with the song. Making reversed graffiti with High Pressure water spray and. The. Dangerous battlefield images. Five women. Five exceptional stories. Hey sarah i want to go to the front. Line and maybe nothing more easy one calling more photography and dramatic pictures from the front lines capturing street full moments in time and even risking death. She gave her life here to tell the stories of people who ended up killing. Women or photographers starting may third on g. W. Fake hair and real stories. Where i come from a lot of women who like me have fake hair sometimes the hair style t