Friday, January 24, 2014

And the "relaxation" begins!

Let's recap: Last summer Dr. R told me about a clinical trial starting in the fall for high risk MGUS and smoldering myeloma patients at the Benson-Henry Institute for Mind/Body Medicine at Mass General Hospital in Boston. The study was going to, "Measure the genomic and psychosocial effects of the Relaxation Response Resiliency Program (3RP) on patients with MGUS and Smoldering Multiple Myeloma". Well, I'm in the study and so far so good!

More information, from the clinical trial listing:

"This research study is evaluating the effects of a mind body medicine intervention called the Relaxation Response Resiliency Program (3RP) on stress and stress related symptoms in patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). This research study is a supportive care trial. This means that the intervention program may improve general well-being and comfort, but is not considered a treatment or "cure" for MGUS or SMM. It is considered an investigational intervention because the investigators are examining the effectiveness of a new program - the 3RP - on reducing stress and stress-related symptoms in patients with MGUS and SMM. Standard management of MGUS and SMM involves regular monitoring without chemotherapy. Mind-body medicine, as defined by the National Institutes of Health, "focuses on the interactions among the brain, mind, body, and behavior, and on the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health." The 3RP is a newly designed group therapy program that through a variety of mind body principles and self-care interventions seeks to buffer stress and promote psychological resiliency and physical well-being. This study will examine the effectiveness of the 3RP in reducing stress and symptoms associated with stress in patients diagnosed with MGUS or SMM. Data from this study will also be used to assess changes in gene expression that result from 3RP intervention, particularly genetic pathways that are known to be dysregulated in MM."

Here is a little background on the Relaxation Response, from the Benson-Henry Institute's website:

The Relaxation Response

In the late 1960s, in the same room in which Harvard Medical School's Walter Cannon performed fight-or-flight experiments 50 years earlier, Herbert Benson, MD, found that there was a counterbalancing mechanism to the stress response. Just as stimulating an area of the hypothalamus can cause the stress response, so activating other areas of the brain results in its reduction. He defined this opposite state the "relaxation response."

The relaxation response is a physical state of deep rest that changes the physical and emotional responses to stress (e.g., decreases in heart rate, blood pressure, rate of breathing, and muscle tension).

When eliciting the relaxation response:

Your metabolism decreases
Your heart beats slower and your muscles relax
Your breathing becomes slower
Your blood pressure decreases
Your levels of nitric oxide are increased

If practiced regularly, it can have lasting effects. Elicitation of the relaxation response is at the heart of the BHI's research and clinical mind/body programs.

So, I was actually accepted into the study in October but I was randomized to the "wait" group. I passed the psychological evaluation (heh) and the program just started a few weeks ago. I have been to the first three sessions of the 3RP program. I have never really meditated before - or tried to elicit the "relaxation response" as BHI calls it - so this has been very new and different for me.

During each of the sessions the psychologist leads the group through a few different methods of eliciting the relaxation response. We also discuss our goals and progress as each participant has to set goals related to exercise, nutrition, sleep, and social connectedness -  social support and prosocial behavior. During the week in between sessions, we have to work on 3 SMART goals related to those areas. Each day we record progress toward those goals, as well as what we do each day to elicit the relaxation response. We were given CDs with guided recordings that we can listen to, but we can also use other recordings via YouTube or other sources that we find that we may prefer. Another part of the "homework" is to record 3-5 "appreciations" each day. Last week we also had to keep a sleep diary and record the time we went to bed and woke up, how many times we woke up in the night, how we felt when we got up, how alert/tired we felt the next day, and how many hours of sleep we got each night. I realized how bad my sleep habits are and how little sleep I get!

I am hopeful that throughout the next several weeks while I am in the program I will gain a lot of tools that I will use for the rest of my life. I'm learning both traditional/formal and simple/practical ways to elicit the relaxation response to counter the stress response. AND... hopefully influence the genetic pathways dysregulated in myeloma. Wouldn't that be nice?!


  1. My therapist has recommended similar things.... relaxed breathing and meditation.... I have tapes she suggested.... if you do not mind please share whatever materials you receive?

  2. Hi Keith!

    I am planning to share as much as I can! :) We were given a CD with 2 ~20 minute recordings (a basic relaxation exercise, and a mindfulness meditation) to listen to daily. However, we were told we could look online (YouTube, etc) and try different guided meditations/mindfulness recordings as well. YouTube has a ton if you search "mindfulness" or "meditation" or "relaxation response" - some as short as a few minutes or as long as an hour. The most important thing is practicing daily, and finding a method/recording that works for you!

    Take care,