By Daniel E. Gershon, DO – Lee’s Summit Physicians Group
I remember one or two years ago watching a news report that showed how the military was using sophisticated virtual reality (VR) to help soldiers, who were burn victims, reduce the need for or strength of narcotics during long and painful medical procedures. Soldiers were put into immersive VR (blocking out all surrounding reality) and then used a program called SnowWorld 3D.
In this game, soldiers were taken through an ice and snow environment where they had to focus on throwing snowballs at snowmen. One hit would freeze them, but a second hit would shatter them. The blue and white colors were intended to create the opposite emotion of the burns that injured their bodies.
Studies have clearly shown that VR can reduce the pain and anxiety of painful medical procedures. Pain requires attention, and the more attention diverted leaves fewer signals to the pain receptors in the brain. So, I began to think about my patients. Pain and anxiety are experienced everyday in a pediatric office. Most kids have a certain degree of fear and anxiety just thinking about getting a vaccine or having blood work done.
I remember my nephew nervously asking me about whether or not he needed any shots at his next check up. I said, ”When is your next visit?” He replied,”In three months!” Typical fear and anxiety only require a patient to hold a parent’s hand, look away, or start a short filibuster by asking questions. Atypical (and not uncommon) fear and anxiety results in patients needing to be held down by parents or staff and can cause post traumatic stress triggered at future visits. It can also result in staff being injured or having an unnecessary needle or blood exposure.
The CHARIOT Program
In my research, I found that VR has just started being used in some children’s hospitals and very few pediatric offices. Most VR use in children’s hospitals are during chemotherapy and pre-op/anesthesia. I reached out to staff at Lucile Packard Children’s Hospital Stanford in California to discuss their CHARIOT program (Childhood Anxiety Reduction through Innovation). They created their own software but used commercially available VR headsets. I learned how and when they implement it and started using VR in my office with patients that I could identify as “high risk” for anxiety.
VR Being Used at Lee’s Summit Physicians Group
Using my own iPhone, a $30 headset from Toys-R-Us, and several VR apps I downloaded from iTunes, I immediately began to see just how powerful distraction and immersion can be.
A 5 year old boy with autism was struggling during the end of his exam. He is non-verbal and had become combative. He still had his kindergarten vaccines left. Sitting on his parent’s lap, we struggled to put the Oculus Go (yes, we upgraded!) headset on him. Once the headset was in place, he instantly became still and started reaching out to grab the manatees during his underwater adventure in an app called Ocean Rift.
Another example? A mother’s jaw dropped when her 8 year old boy made it through blood work without even flinching. Last year he had to be held down by his mother and staff to have blood work done. “This is amazing!” she said.
Currently, our office is using the Oculus Go (VR) headset for patients 5 years of age and older who have a high likelihood of anxiety with a painful procedure. There are approximately 8 different immersion experiences for them to choose from ranging from underwater Ocean Rift, Star Wars Droid Repair, Learning to fly an airplane, to more adolescent experiences like traveling through the body or moving in and out of the International Space Station.
The results over the past 6 months have been impressive, but it doesn’t work for every patient. Some patients have to see what is happening, but most are completely immersed in a dazzling 360 degree world with amazing graphics and sound. We will ask, but if you’re interested in your child using VR at his/her next appointment, feel free to ask your nurse or provider about it.