Virtual Reality: Digital Medicine to Combat Pain

Amanda Greene lives with pain.

“If I don’t have nerve pain, I might have joint pain. If I’m not having joint pain, I might have headaches,” Greene said.

The unrelenting pain is a symptom of lupus, an autoimmune disease in which a patient’s immune system attacks the body. Greene has tried acupuncture, massage and opioids, but realized she was allergic to the addictive pain medicine.

The newest therapy that excites her: virtual reality. Greene participated in a test through the company “appliedVR” to see if and how virtual reality could help patients. Greene’s virtual experience helped her to relax and trained her to breathe in a specific way. She saw a tree, crystals, water and her breath as she was guided to inhale and exhale.

“It worked. It works for me,” Greene said. “It’s the quality of life, it is the range of motion, it is like, forget about quality of life, it is the life.” 

VR in hospitals and clinics

Brennan Spiegel is a gastroenterologist who has used VR for his patients. He said abdominal pain and gastrointestinal discomfort, in some cases, are related to a patient’s mental state.

“Something like virtual reality actually can intercede in the brain-gut axis and sort of rewire the neurocircuitry in a way that helps to reduce abdominal pain,” said Spiegel, who is also director of Health Services Research at Cedars-Sinai and heads its virtual reality program.

More than 2,500 patients have been treated with virtual reality at Cedars-Sinai, a hospital with the largest documented therapeutic VR program in the world, according to Spiegel.

“Virtual reality can reduce pain, can reduce blood pressure, can improve quality of life, reduce anxiety and now, we’re looking to see can it do really important things like reduce the need for opioids.”

Spiegel said more than 100 hospitals across the United States are using VR as a form of therapy for patients to help manage symptoms such as pain and anxiety. He said an increasing number of countries worldwide are taking an interest, and doctors are starting to develop international guidelines on how to apply and validate the technology in health care.

Spiegel is now taking virtual reality outside the hospital to partner clinics such as Attune Health in Los Angeles, where many of the patients suffer from autoimmune or inflammatory diseases that cause symptoms such as joint pain.

A rheumatologist and founder of Attune Health, Swamy Venuturupalli is conducting a study on how VR can reduce the pain levels of patients in his clinic. Virtual experiences include swimming with dolphins and meditation exercises before a campfire. Venuturupalli said VR is not just a distraction for patients experiencing pain; it can also train them in deep breathing exercises and biofeedback.

“It allows you to connect with that part of your brain that you’re normally not in contact with — the part of the brain that controls respiration, the part of the brain that controls your heart rate and the emotional part of your brain,” Venuturupalli said.

Doctors are also looking into the potential side effects of VR, such as whether it could be addictive.

“It’s probably unlikely and, in fact, we have not seen abuse amongst our patients who are using it for therapeutic purposes rather than for gaming or entertainment,” Spiegel said.

The most common side effect for some patients, according to Spiegel, is “simulator sickness,” the feeling of dizziness and nausea when the patient is wearing a VR headset. He said less than 10 percent of patients experience this, but the symptoms quickly disappear when the headset comes off.

VR pharmacy and clinics

The company appliedVR uses immersive technology to help people manage pain and anxiety. It also is developing content and working with people in entertainment and academia to find VR experiences appropriate for patients. The vision is to have a VR pharmacy. 

“You need a wide variety of content because you have a wide variety of people in health care. From infancy to geriatrics and with every personality type,” said Josh Sackman, president and co-founder of appliedVR.

Swimming with dolphins may relax one patient, yet terrify another. Greene said watching a fashion show in virtual reality helps her escape her pain.

The medical world’s reaction to using VR in the clinical setting has changed in the past three years, said Sackman. In 2015, he experienced skepticism among doctors who wondered why television or a tablet couldn’t be used to distract patients. Sackman said that unlike a screen, VR blocks out the sights and sounds of a hospital or clinic as soon as the patient puts on the VR headset.

“In a matter of moments, you see a patient who is in agony, in terrible pain, stressed, having panic and all of a sudden, their body relaxes, a smile comes on their face and you see a physical transformation,” Sackman said.

Spiegel would like to create outpatient VR clinics. He said the aim is not to have patients stay in VR forever.

“The idea is to learn while you’re in virtual reality, that you do have governance over your body, that the mind matters and that you can learn these skills that are then reproduceable and could be called upon when you need them in the real world,” Spiegel said.

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Virtual Reality: Digital Medicine to Combat Pain

Amanda Greene lives with pain.

“If I don’t have nerve pain, I might have joint pain. If I’m not having joint pain, I might have headaches,” Greene said.

The unrelenting pain is a symptom of lupus, an autoimmune disease in which a patient’s immune system attacks the body. Greene has tried acupuncture, massage and opioids, but realized she was allergic to the addictive pain medicine.

The newest therapy that excites her: virtual reality. Greene participated in a test through the company “appliedVR” to see if and how virtual reality could help patients. Greene’s virtual experience helped her to relax and trained her to breathe in a specific way. She saw a tree, crystals, water and her breath as she was guided to inhale and exhale.

“It worked. It works for me,” Greene said. “It’s the quality of life, it is the range of motion, it is like, forget about quality of life, it is the life.” 

VR in hospitals and clinics

Brennan Spiegel is a gastroenterologist who has used VR for his patients. He said abdominal pain and gastrointestinal discomfort, in some cases, are related to a patient’s mental state.

“Something like virtual reality actually can intercede in the brain-gut axis and sort of rewire the neurocircuitry in a way that helps to reduce abdominal pain,” said Spiegel, who is also director of Health Services Research at Cedars-Sinai and heads its virtual reality program.

More than 2,500 patients have been treated with virtual reality at Cedars-Sinai, a hospital with the largest documented therapeutic VR program in the world, according to Spiegel.

“Virtual reality can reduce pain, can reduce blood pressure, can improve quality of life, reduce anxiety and now, we’re looking to see can it do really important things like reduce the need for opioids.”

Spiegel said more than 100 hospitals across the United States are using VR as a form of therapy for patients to help manage symptoms such as pain and anxiety. He said an increasing number of countries worldwide are taking an interest, and doctors are starting to develop international guidelines on how to apply and validate the technology in health care.

Spiegel is now taking virtual reality outside the hospital to partner clinics such as Attune Health in Los Angeles, where many of the patients suffer from autoimmune or inflammatory diseases that cause symptoms such as joint pain.

A rheumatologist and founder of Attune Health, Swamy Venuturupalli is conducting a study on how VR can reduce the pain levels of patients in his clinic. Virtual experiences include swimming with dolphins and meditation exercises before a campfire. Venuturupalli said VR is not just a distraction for patients experiencing pain; it can also train them in deep breathing exercises and biofeedback.

“It allows you to connect with that part of your brain that you’re normally not in contact with — the part of the brain that controls respiration, the part of the brain that controls your heart rate and the emotional part of your brain,” Venuturupalli said.

Doctors are also looking into the potential side effects of VR, such as whether it could be addictive.

“It’s probably unlikely and, in fact, we have not seen abuse amongst our patients who are using it for therapeutic purposes rather than for gaming or entertainment,” Spiegel said.

The most common side effect for some patients, according to Spiegel, is “simulator sickness,” the feeling of dizziness and nausea when the patient is wearing a VR headset. He said less than 10 percent of patients experience this, but the symptoms quickly disappear when the headset comes off.

VR pharmacy and clinics

The company appliedVR uses immersive technology to help people manage pain and anxiety. It also is developing content and working with people in entertainment and academia to find VR experiences appropriate for patients. The vision is to have a VR pharmacy. 

“You need a wide variety of content because you have a wide variety of people in health care. From infancy to geriatrics and with every personality type,” said Josh Sackman, president and co-founder of appliedVR.

Swimming with dolphins may relax one patient, yet terrify another. Greene said watching a fashion show in virtual reality helps her escape her pain.

The medical world’s reaction to using VR in the clinical setting has changed in the past three years, said Sackman. In 2015, he experienced skepticism among doctors who wondered why television or a tablet couldn’t be used to distract patients. Sackman said that unlike a screen, VR blocks out the sights and sounds of a hospital or clinic as soon as the patient puts on the VR headset.

“In a matter of moments, you see a patient who is in agony, in terrible pain, stressed, having panic and all of a sudden, their body relaxes, a smile comes on their face and you see a physical transformation,” Sackman said.

Spiegel would like to create outpatient VR clinics. He said the aim is not to have patients stay in VR forever.

“The idea is to learn while you’re in virtual reality, that you do have governance over your body, that the mind matters and that you can learn these skills that are then reproduceable and could be called upon when you need them in the real world,” Spiegel said.

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Virtual Reality: Digital Medicine to Combat Pain

More than 100 hospitals across the United States are using virtual reality or VR, as a form of therapy for patients to help manage symptoms such as pain and anxiety. An increasing number of countries worldwide are taking an interest in VR and doctors are starting to develop international guidelines on how to apply and validate VR in healthcare. VOA’s Elizabeth Lee reports from Los Angeles, where one hospital is leading the effort in using VR as digital medicine.

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Virtual Reality: Digital Medicine to Combat Pain

More than 100 hospitals across the United States are using virtual reality or VR, as a form of therapy for patients to help manage symptoms such as pain and anxiety. An increasing number of countries worldwide are taking an interest in VR and doctors are starting to develop international guidelines on how to apply and validate VR in healthcare. VOA’s Elizabeth Lee reports from Los Angeles, where one hospital is leading the effort in using VR as digital medicine.

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US Economy Grows a Bit Faster Than First Thought

The U.S. economy expanded at a 4.2 percent annual rate in April, May and June. 

The second-quarter growth figure is one-tenth of a percent higher than initial estimates.

“The economy is in good shape,” according to PNC Bank Chief Economist Gus Faucher. He writes that this is the best “year-over-year increase in three years.”

But Faucher also says growth above four percent is “unsustainable” and the economy is “set to slow somewhat in the second half of 2018,” and hit 3.4 percent for the whole year. He predicts U.S. economic growth will slow further in 2019 and 2020 as the “stimulus from tax cuts and spending increases fades.”

Wednesday’s report from the Commerce Department is a routine revision made as more complete data becomes available.

Growth figures were boosted by a decline in imports, particularly petroleum, and by some temporary factors.

One of those factors is a surge in soybean exports, which were rushed at a faster-than-usual pace to beat tariffs imposed by China in retaliation for new tariffs imposed by the Trump administration on Chinese goods.

The new second-quarter figures are nearly double the performance in January, February and March.

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US Economy Grows a Bit Faster Than First Thought

The U.S. economy expanded at a 4.2 percent annual rate in April, May and June. 

The second-quarter growth figure is one-tenth of a percent higher than initial estimates.

“The economy is in good shape,” according to PNC Bank Chief Economist Gus Faucher. He writes that this is the best “year-over-year increase in three years.”

But Faucher also says growth above four percent is “unsustainable” and the economy is “set to slow somewhat in the second half of 2018,” and hit 3.4 percent for the whole year. He predicts U.S. economic growth will slow further in 2019 and 2020 as the “stimulus from tax cuts and spending increases fades.”

Wednesday’s report from the Commerce Department is a routine revision made as more complete data becomes available.

Growth figures were boosted by a decline in imports, particularly petroleum, and by some temporary factors.

One of those factors is a surge in soybean exports, which were rushed at a faster-than-usual pace to beat tariffs imposed by China in retaliation for new tariffs imposed by the Trump administration on Chinese goods.

The new second-quarter figures are nearly double the performance in January, February and March.

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White House Counsel Don McGahn to Depart

White House counsel Don McGahn, criticized by allies of President Donald Trump for extensively cooperating with the special counsel, will soon leave his job after months of speculation that he was on his way out.

Trump announced the development on Twitter.

Trump said McGahn will oversee the inside Washington campaign to win Senate confirmation next month of federal appellate court judge Brett Kavanaugh to the U.S. Supreme Court.

McGahn has been shepherding Kavanaugh to senators’ offices in recent weeks for lengthy introductory meetings with the lawmakers ahead of Kavanaugh’s confirmation hearings that start next Tuesday. The White House is hopeful the Senate will confirm Kavanaugh’s Supreme Court nomination in time for him to join the court when its new term starts October 1.

Wednesday’s announcement comes amid reported tension between Trump and McGahn, who is said to have been interviewed several times by investigators working for special counsel Robert Mueller. Mueller is seeking to determine whether the president obstructed justice in the probe of ties between Trump’s election campaign and Russia.

Reports said McGahn answered questions about many of the inside-the-White House events related to actions that Trump has taken, although McGahn’s lawyer said he did not implicate the president in wrongdoing.

Exasperation with Trump’s temper prompted McGahn to nickname the president “King Kong,” according to a recent article in The New York Times.

“McGahn’s relationship with the president has been strained for quite a while due to the ongoing Russia probe,” Bradley Moss, a national security lawyer, told VOA.

“His likely successor, Emmet Flood, is far better suited experience-wise to lead the legal response” to the special counsel’s requests, said Moss, the deputy executive director of the James Madison Project.

McGahn has been viewed inside the White House and among conservatives as a critical member of Trump’s team, leading the successful effort to put like-minded judges on federal benches and cutting government regulation.

McGahn “has been very effective at implementing the president’s priority of appointing highly qualified judges who have a traditional, modest understanding of their role in our system of government,” according to Thomas Jipping, deputy director for legal and judicial studies at the Heritage Foundation.

“That process has a lot of moving parts and political volatility, but Don has stayed on target and kept it moving,” Jipping told VOA.

The White House counsel was asked by the president in June of 2017 to fire Mueller. According to media reports McGahn, who had been the Trump campaign and transition team top lawyer, refused and threatened to resign.

The 50-year-old former chair of the Federal Election Commission would become the latest in a long line of officials who have left Trump’s 19-month presidency, either officials who have been fired, pushed out or voluntarily departed.

His departure will come as the White House prepares for a likely onslaught of congressional investigations if the Democrats retake the House of Representatives in the November midterm election.

VOA’s Ken Bredemeier contributed to this report.

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White House Counsel Don McGahn to Depart

White House counsel Don McGahn, criticized by allies of President Donald Trump for extensively cooperating with the special counsel, will soon leave his job after months of speculation that he was on his way out.

Trump announced the development on Twitter.

Trump said McGahn will oversee the inside Washington campaign to win Senate confirmation next month of federal appellate court judge Brett Kavanaugh to the U.S. Supreme Court.

McGahn has been shepherding Kavanaugh to senators’ offices in recent weeks for lengthy introductory meetings with the lawmakers ahead of Kavanaugh’s confirmation hearings that start next Tuesday. The White House is hopeful the Senate will confirm Kavanaugh’s Supreme Court nomination in time for him to join the court when its new term starts October 1.

Wednesday’s announcement comes amid reported tension between Trump and McGahn, who is said to have been interviewed several times by investigators working for special counsel Robert Mueller. Mueller is seeking to determine whether the president obstructed justice in the probe of ties between Trump’s election campaign and Russia.

Reports said McGahn answered questions about many of the inside-the-White House events related to actions that Trump has taken, although McGahn’s lawyer said he did not implicate the president in wrongdoing.

Exasperation with Trump’s temper prompted McGahn to nickname the president “King Kong,” according to a recent article in The New York Times.

“McGahn’s relationship with the president has been strained for quite a while due to the ongoing Russia probe,” Bradley Moss, a national security lawyer, told VOA.

“His likely successor, Emmet Flood, is far better suited experience-wise to lead the legal response” to the special counsel’s requests, said Moss, the deputy executive director of the James Madison Project.

McGahn has been viewed inside the White House and among conservatives as a critical member of Trump’s team, leading the successful effort to put like-minded judges on federal benches and cutting government regulation.

McGahn “has been very effective at implementing the president’s priority of appointing highly qualified judges who have a traditional, modest understanding of their role in our system of government,” according to Thomas Jipping, deputy director for legal and judicial studies at the Heritage Foundation.

“That process has a lot of moving parts and political volatility, but Don has stayed on target and kept it moving,” Jipping told VOA.

The White House counsel was asked by the president in June of 2017 to fire Mueller. According to media reports McGahn, who had been the Trump campaign and transition team top lawyer, refused and threatened to resign.

The 50-year-old former chair of the Federal Election Commission would become the latest in a long line of officials who have left Trump’s 19-month presidency, either officials who have been fired, pushed out or voluntarily departed.

His departure will come as the White House prepares for a likely onslaught of congressional investigations if the Democrats retake the House of Representatives in the November midterm election.

VOA’s Ken Bredemeier contributed to this report.

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Florida Governor’s Race: Trump Supporter Vs. Mayor Who Wants President Impeached

A Florida congressman with strong backing from U.S. President Donald Trump and an African-American mayor who thinks Trump ought to be impeached are set to square off in the November election for the Florida governorship in the key political battleground state.

The coming political contest between Republican Congressman Ron DeSantis, who has Trump’s staunch support, and Democrat Andrew Gillum, now mayor of the state capital of Tallahassee, was set Tuesday when both won their parties’ primary elections.

DeSantis had been expected to win the Republican gubernatorial nomination, but Gillum pulled an upset, marshaling the support of minority voters to surge past better-financed Democratic opponents after trailing them in pre-election political surveys of voters. Bernie Sanders, the self-described democratic socialist who unsuccessfully sought the 2016 Democratic presidential nomination, had endorsed Gillum’s candidacy.

The DeSantis-Gillum race is likely to be one of the most closely watched elections in the Nov. 6 voting for what it might portend about the 2020 presidential election when Trump seeks another term in the White House.

Trump won the southeastern state of Florida in 2016, but it is a politically divided state that both Republican and Democratic contenders have won in recent elections. The outcome of the governor’s race could give a hint whether Trump’s political fortunes have changed.

Trump wasted no time assailing Gillum, saying Wednesday on Twitter that he has “allowed crime & many other problems to flourish in his city.”

Even before the voting ended the night before, Trump said, “Such a fantastic win for Ron DeSantis and the people of the Great State of Florida. Ron will be a fantastic Governor. On to November!”

DeSantis paid tribute to Trump at his victory party, saying, “I’m not always the most popular guy in D.C., but I did have support from someone in Washington. If you walk down Pennsylvania, he lives in the white house with the pillars in front of it. I was able to talk to the president, and I want to thank him for his support.”

Gillum, who would become Florida’s first black governor, has criticized Trump as far back as last December.

“This president is wrong for Florida on almost every issue, and as governor, I will fight against each and every one of his wrong-headed, racist and sexist policies,” Gillum said in a video. “The Donald Trump presidency shouldn’t even make it through 2018. He should be impeached now.”

Arizona race

Trump also weighed in with strong support for Congresswoman Martha McSally, who won a three-way Republican primary for a Senate nomination in the southwestern state of Arizona. McSally aligned herself with Trump as she defeated two other conservatives who also voiced support for the president.

McSally now will face Democratic Congresswoman Kyrsten Sinema, who has been running a centrist campaign, to replace incumbent Republican Senator Jeff Flake. Flake declined to seek re-election after losing support, largely because many Arizona Republicans disapproved of his attacks on Trump.

Sinema has taken a small, early lead in voter surveys over McSally, but University of Virginia political analyst Larry Sabato told CNN that the Arizona contest will be “very, very competitive. It’ll go right down to the wire.”

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Florida Governor’s Race: Trump Supporter Vs. Mayor Who Wants President Impeached

A Florida congressman with strong backing from U.S. President Donald Trump and an African-American mayor who thinks Trump ought to be impeached are set to square off in the November election for the Florida governorship in the key political battleground state.

The coming political contest between Republican Congressman Ron DeSantis, who has Trump’s staunch support, and Democrat Andrew Gillum, now mayor of the state capital of Tallahassee, was set Tuesday when both won their parties’ primary elections.

DeSantis had been expected to win the Republican gubernatorial nomination, but Gillum pulled an upset, marshaling the support of minority voters to surge past better-financed Democratic opponents after trailing them in pre-election political surveys of voters. Bernie Sanders, the self-described democratic socialist who unsuccessfully sought the 2016 Democratic presidential nomination, had endorsed Gillum’s candidacy.

The DeSantis-Gillum race is likely to be one of the most closely watched elections in the Nov. 6 voting for what it might portend about the 2020 presidential election when Trump seeks another term in the White House.

Trump won the southeastern state of Florida in 2016, but it is a politically divided state that both Republican and Democratic contenders have won in recent elections. The outcome of the governor’s race could give a hint whether Trump’s political fortunes have changed.

Trump wasted no time assailing Gillum, saying Wednesday on Twitter that he has “allowed crime & many other problems to flourish in his city.”

Even before the voting ended the night before, Trump said, “Such a fantastic win for Ron DeSantis and the people of the Great State of Florida. Ron will be a fantastic Governor. On to November!”

DeSantis paid tribute to Trump at his victory party, saying, “I’m not always the most popular guy in D.C., but I did have support from someone in Washington. If you walk down Pennsylvania, he lives in the white house with the pillars in front of it. I was able to talk to the president, and I want to thank him for his support.”

Gillum, who would become Florida’s first black governor, has criticized Trump as far back as last December.

“This president is wrong for Florida on almost every issue, and as governor, I will fight against each and every one of his wrong-headed, racist and sexist policies,” Gillum said in a video. “The Donald Trump presidency shouldn’t even make it through 2018. He should be impeached now.”

Arizona race

Trump also weighed in with strong support for Congresswoman Martha McSally, who won a three-way Republican primary for a Senate nomination in the southwestern state of Arizona. McSally aligned herself with Trump as she defeated two other conservatives who also voiced support for the president.

McSally now will face Democratic Congresswoman Kyrsten Sinema, who has been running a centrist campaign, to replace incumbent Republican Senator Jeff Flake. Flake declined to seek re-election after losing support, largely because many Arizona Republicans disapproved of his attacks on Trump.

Sinema has taken a small, early lead in voter surveys over McSally, but University of Virginia political analyst Larry Sabato told CNN that the Arizona contest will be “very, very competitive. It’ll go right down to the wire.”

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