25 March 2008

A Novel Application of Phototherapy in the ER

Anybody who has cared for premature infants or neonates with jaundice is familiar with the Bili-Blanket, a form of phototherapy in which blue light at about 450nm isomerizes bilirubin into a form which is water-soluble and more easily excreted.

Similarly, those in the frigid North of Alaska and Canada are aware of the value of phototherapy for Seasonal Affective Disorder. The long nights up there can induce depression, so very intense light sources are used to stimulate the pineal gland, which can ameliorate the depressive effect of the prolonged darkness.

In our ER, we have many times noted the efficacy and value of a type of phototherapy, which we call "fluorescent therapy."

A typical application would be a patient who presents with a number of vague, constitutional symptoms which appear on the initial examination not to herald any serious medical condition, but are serious enough to justify a work-up, perhaps with labs or some sort of time-consuming imaging study. The patient, during this evaluation, is placed in a room illuminated by a standard industrial fluorescent tube bulb, and there they remain for several hours, bathed in its flickering, blue-ish glow, while awaiting the results of their tests.

After completion of a non-standard time course of this phototherapy (150-210 minutes in most cases), a high frequency of spontaneous remission of symptoms is noted, and without further intervention, the patient reports feeling better and wanting to go home. Outcomes indicate that the one-month mortality for patients treated with and responding to fluorescent therapy is exceedingly low, approaching zero.

Further research is needed into other potential applications of this novel form of phototherapy.

6 comments:

  1. I have also observed a synergistic response when combined with juice and crackers! More research is needed!

    Great post :-)

    ReplyDelete
  2. My brother has found this treatment is very helpful with his anxiety attacks. I understand on several occassions he went to the ER waiting room without even checking in and found it to be advantageous, although, I also understand there are folks who encourage you to check in once your in the waiting room. I think that is fair, given his exploitation of this experimental therapy.

    ReplyDelete
  3. At high latitudes the northern lights help take our minds of the lack of sun in the winter....ahh the best kind of phototherapy!!

    ReplyDelete
  4. Beyond the 210 minute mark, suprising change in demeanor...with desire to leave and resolution of symptoms, diva like attitude and occasional swearing seem to be more prominent. As a nurse, similar attitude and demeanor also present at the 600 minute mark...go figure.

    ReplyDelete
  5. Perhaps this would be a good rationale for my goal of getting my insurer to pay for thalassotherapy. It's an old treatment, but a goody: for those who don't have time to check, it's going to the seaside for one's health. If a period of time under fluorescent lights is that good, think how much better a period of time under the sun on the beach would be! And the cost would be no more than most ED visits. Still, I haven't been able to get my insurer to cover my trip to Jamaica....

    ReplyDelete
  6. Brilliant, Marshall!
    Actually, how about this: In every ED there should be a sign, "Waiting time to see a doctor: Six hours. Distance to the beach: Two hours. Please consider"

    ReplyDelete