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Humorous Healing | The Annex Gleaner

When you’re 29 years old, newly married, and suddenly diagnosed with an incurable disease, it’s hard to find things to laugh about.

That’s what happened to Zal Press more than 30 years ago. After he was diagnosed with Crohn’s Disease, friends and family started treating him differently. When they were around him, they were around him, they were all deeply concerned and they could never act casually. He was no longer a ‘person’; he became a ‘patient,’

Like most patients, he just did whatever the doctor told him, hoping the problem would be solved. “Just give me a pill so I can get on with my life,” said Press, reflecting on how he felt back then.

But after obeying doctors’ orders and being compliant for so long, Press stopped being passive. He began asking questions, he started looking Crohn’s Disease critically. In short, he took his healthcare into his own hands.

Today, Press is trying to encourage other patients to do the same with Patient Commando, the entertainment company he founded.

Located in the Bloor and Bathurst area, Patient Commando’s mission is “getting patients engaged with their own healthcare,” according to Press.

The company does this through live theatre, public speaking, and humour therapy workshops, giving patients the tools to tell their own patient story and empower their lives.

Humour therapy uses materials such as books, shows, movies, or stories to encourage spontaneous discussion of the patients’ own experiences. This can be provided individually or in a group setting.

This isn’t a groundbreaking practice. It has been researched, documented, and put into use for many years in other parts of the world. Indeed, humour therapy is a credible and accepted treatment in places like the United Kingdom, where patient storytelling is regularly used as a educational tool for practitioner awareness and patient empowerment.

Only recently though has it hit the North American shores, with Patient Commando being the first theatre or its kind in Toronto.

Zal Press hopes that Patient Commando, with the help of its Creative Director, Brian G. Smith, and his company You and Media, will “act as a cultural bridge between stakeholders” by presenting the patient’s experience, increasing practitioner awareness of the patient’s conditions and ultimately improving the patient’s environment. Press firmly believes in this approach because “patients and practitioners have the same goal”: the well-being of the patient, and everyone has something to gain from shows like Cancer Can’t Dance Like This by Daniel Stolfi, the comedic dramatization of his two-year battle with cancer.

Patient Commando debuted on May 12 with a presentation of Stolfi’s critically acclaimed one-man show at the Glenn Gould Studio at the CBC Broadcast Centre. This presentation was conducted as a fundraiser for the benefit of Lilah’s Fund, dedicated to SickKids’ research into neuroblastoma, a cancer most commonly diagnosed in children under the age of five.

“When the story is funny, it really has the power to change lives,” said Press.

– Jonathan Lee, The Annex Gleaner

Published in The Annex Gleaner, June 2011

Hypertension success stories boost BP control | TheHeart.org

The first randomized controlled trial to examine the effect of a culturally appropriate storytelling intervention on control of blood pressure has shown some success, with those who were uncontrolled at baseline improving systolic BP by 11 mm Hg over the course of the study, published in the January 18, 2011 issue of the Annals of Internal Medicine [1].

Dr Thomas K Houston (University of Massachusetts, Worcester) and colleagues created DVDs of real African American patients from a low-income, inner-city setting telling their own stories of how they battled hypertension [2]. They showed these to half of the people in their study, while the remainder saw a “control” DVD that covered health topics not related to hypertension. The BP reductions seen, particularly in those with uncontrolled hypertension at baseline, are “similar” to those achieved with pharmaceutical interventions and dietary approaches, say Houston et al.

“I do think that storytelling is innately human. It’s a way we make meaning out of the world and understand our lives,” Houston told heartwire. “So it does apply across the board, it has value for everyone, although there is evidence that the benefit is greater for those of lower literacy.”

I do think that storytelling is innately human. It’s a way we make meaning out of the world and understand our lives.

He acknowledges that further work is needed to fine-tune these findings. “But we can envision a future where providers would refer patients to websites or DVDs that would have a pool of stories featuring people like them, which would help them manage themselves. Communicating with patients has value, and we have packaged that into something easily disseminated.”

In an accompanying editorial [3], Drs Kimberley R Myers and Michael J Green (Penn State College of Medicine, Hershey) say Houston et al “have done much to corroborate anecdotal evidence that storytelling can benefit patients with chronic illness.” However, they add that their claims that the intervention is as effective as pharmacologic therapy are “overstated” and that “stories are unlikely to become a routine part of treatment until additional evidence shows that their effect is both sustainable and generalizable.”

Narrative communication: A well-known marketing tool

Houston explained to heartwire that the notion of storytelling—or “narrative communication,” as it is termed by industry—is well-recognized as being a powerful force in marketing. There is also a national community of scientists working with the concept in healthcare, he says, including some “wonderful work” done with storytelling that has been successful in increasing the rates of breast-cancer screening.

Communicating with patients has value and we have packaged that into something easily disseminated.

He and his colleagues decided to test the concept in blood-pressure control, which is poor in particular sectors of society, including among African Americans. Evidence suggests “that storytelling may offer a unique opportunity to promote evidence-based choices in a culturally appropriate context,” Houston notes, helping listeners make meaning of their lives and influencing them if they actively engage in a story. This is based on the idea of “homophily,” he says, whereby people identify themselves with the storyteller and picture themselves taking part in the action, making them susceptible to behavior-change messages and suggested new ways of interacting with family healthcare providers.

“What we did is we went into a community hospital in Birmingham, AL and recruited patients to tell us their stories of success and then packaged them into an interactive DVD that we then redeployed in a randomized trial,” Houston says. “We worked with people who had expertise in documentary film-making, so we edited these productions so they would be stories, with a beginning, middle, an end, and a conclusion.”

Most benefit seen in group with uncontrolled BP at baseline

The researchers then took African American patients from a hypertension clinic in Birmingham, some of whom were controlled on medication at the start of the trial (n=172) and some of whom were uncontrolled (n=123). The controlled patients were included to see whether the intervention would be useful in maintaining BP control, Houston said.

Half of the patients received the intervention, a series of three DVDs that contained patient stories delivered at baseline, three months, and six months. The control group got the attention DVDs.

“We did stratified randomization—two randomized trials in one—which allows us to see the overall effect of the study but also to maintain randomization when comparing the subgroups,” Houston explained. “We did find a significant, positive overall effect for systolic BP in the overall cohort, including everyone together. But the change in the uncontrolled was driving the change; there was very little effect in the controlled group.”

Change over time in mean BP for the intervention vs comparison groups

Subgroup and BP measure Estimated regression coefficient,* baseline to 3 mo p Estimated regression coefficient,* baseline to 69 mo p
All patients
Systolic 6.53 0.014 6.41 0.019
Diastolic 3.05 0.058 2.66 0.109
Controlled hypertension at baseline
Systolic 1.12 0.71 0.44 0.89
Diastolic -0.19 0.92 0.88 0.67
Uncontrolled hypertension at baseline
Systolic 11.21 0.012 11.9 0.007
Diastolic 6.43 0.012 4.22 0.119
*Positive differences indicate greater blood-pressure reduction in the intervention group than in the comparison group

Could Twitter, YouTube, and Facebook be employed to control BP?

Houston et al note some limitations of their study, including the high dropout rate of 25% and the fact that they could not confirm whether patients actually watched the DVDs that were mailed to their homes. “Additional studies are needed to clarify the mechanisms through which storytelling works, address more long-term follow-up, and test similar interventions for different populations and conditions,” they conclude.

Physicians might actually include a prescription for stories along with one for medication, a development we would welcome.

But should this ultimately be proven to be a useful intervention, social networking media such as Twitter, YouTube, and Facebook could be used to make such narratives readily accessible, say Myers and Green in their editorial. “Physicians might actually include a prescription for stories along with one for medication, a development we would welcome,” they state.

Lisa Nainggolan, TheHeart.org http://www.theheart.org/article/1174127.do

The Best Medicine? | Metro News

Patient Commando gets the blood pumping with a big dose of its laughter therapy program. The non-profit group helps support those with chronic disease, in severe pain.

They’re not sick jokes, but rather jokes for the sick.

A new, non-profit company called Patient Commando is making sure that stories about health struggles — both sad and funny — get told and listened to. Laughter therapy has long been known as a powerful tool to release tension and get the blood pumping more efficiently.

In Patient Commando’s promotional video, a comedic actor spoofs everyone’s worst hospital nightmare.

Donning his hat, socks and shoes, he tries to make a dignified exit, but his hospital gown isn’t done up and his bare bum jiggles hilariously for all to see.

Comic relief — through laugh therapy and live theatre shows — is one of the ways that Patient Commando helps support people who have chronic disease, terminal disease or are suffering from bereavement.

The company also encourages people to tell their stories. “I’m interested in the expression of the story,” says Toronto founder of Patient Commando Zal Press.

“Listen to the patient voice.”

Press himself has struggled with the painful symptoms of Crohn’s disease, an inflammation of the intestines, for 30 years. “It feels like a cat trapped inside my gut trying to claw its way out,” he tells Metro.

Press gave up his job selling home decor to start Patient Commando. The company will be conducting public “laugh therapy” workshops at the Centre for Social Innovation in Toronto from June 15 to July 30.

For more information, go to www.patientcommando.com

– Celia Milne, Metro

Published in Metro – Wellness Section – Tuesday, June 14, 2011

Good laughs: It seems obvious that laughing is good for us, but is there actual evidence? Spanish researchers assessed all the literature they could find about laughter therapy. A good chuckle has health benefits that are:

  • Physical
  • Psychological
  • Social
  • Spiritual
  • Quality-of-life relate

Partnering with patients to improve care | HIROC News

Several recent news items point to an interest in Canadian healthcare providers partnering with patients to heighten patient safety and healthcare.

Rather than providers positioning as the experts dictating interventions, some are looking to patients for their perspective on their own care and the larger system.

At the Saskatoon Health Region, senior managers are conducting weekly walkarounds where they engage front-line staff, patients and their families in dialogue about patient-safety issues.

The goal is to heighten the culture of safety through a conversation identifying issues and solutions, and it’s working, says vice-president of clinical and operation support services Sandra Blevins.

“We have quite lively discussions around care aspects, and educate patients about their role in patient safety.

“The culture shift is starting to happen,” she adds.

On June 20, Barbara Balik, a senior faculty member at the Institute for Health Information and CEO of Common Fire Healthcare Consulting, delivers a keynote in Toronto on the importance of partnering with patients and families.

In an earlier interview with Axiom News, Balik highlighted the value of those partnerships in light of the Excellent Care for All Act, noting they can contribute to a better designed system for effective cross-continuum care.

“If we partner with patients and families on very (aspect of the act), it will help us get better,” says Balik.

And Zal Press, who has had Crohn’s disease for 30 years, has launched an entertainment production company, with the goal of showcasing — through live theatre, public speaking and humour therapy — what it’s like to be a patient.

His debut production, Cancer Can’t Dance Like This, took place May 12 in Toronto at the Glenn Gould Studio, CBC Broadcast Centre.

Press says his hope is that healthcare providers in particular are inspired by the entertainment to begin to see the patient perspective in a new way and lead practice change towards a “culture of safety.”

– Michelle Strutzenberger, Axiom News

http://www.hiroc.com/AxiomNews/2011/May/May18.html