Is it possible to cure Skumin syndrome?

The Skumin syndrome develops in some patients with cardiac valve disease in the postoperative period after implantation of artificial heart valves. Thinking and behaviour of patients differ specifically. The attention is concentrated on the prosthesis functioning. There appear unusual sensations from a heart when a person fears possible breakdown of artificial valves, ball splitting and tearing off a prosthesis. A person is depressed, miserable, alarmed, with a special kind of dismay (how to live with "a piece of iron in the heart", with a prosthesis in the "motor of life"). Patients tend to keep themselves away from petty physical or emotional tenseness, introducing inadequate self-restrictions in the routine. They avoid walks, medical physical training and other adequate work, supposing this can prevent early wear of artificial valves. Sleep disorder is typical of 76.6% of the patients. At night they cannot fall asleep because they listen to a heart beat, count the number of extra-systoles, note petty changes in the heart rhythm and melody of the implanted prosthesis. On the contrary, in the daytime, when it is noisy they can have sound sleep. Neurologically a patient has vegetative faults -- painfulness in the zones of solar plexus and carotid artery, arterial hypotension. The research registered faults in mental activity of the patients with a prosthesis. It considerably hampers the realization of rehabilitation programmes. Systematic use of special psychotherapeutic and prophylactic measures is required for the correction and prevention of these faults.

Psychotherapy

Preparatory stage:

• mental state study,
• establishment of contact,
• psychological preparation for the process of equipping with a prosthesis of valve heart device. Aspects of psychoprophylaxis are as follows: teaching patients to adjust to conditions of life, preventing psychotraumatic and stressful influence, supporting positive emotional tone, regulating industrial and appliance load, maintaining favourable sanitary conditions, wise use of one's knowledge and experience.

Sedative-mobilizing stage:

• calming down of the operated on,
• forming adequate attitude to the postoperational period,
• working out active personal positions.

Psychotraining according to V. Skumin is one of the effective psychotherapeutic methods and it includes five exercises:

• «Relaxation»- successive muscle debilitation of legs, arms, trunk, neck, head.

Special attention is paid to relaxation of hands, back, face, excessive tenseness of which is especially expressed in this cohort of people.

• «Warmness» -- is generated in legs, arms, solar plexus, neck and head.

Patients with artificial heart valves and Skumin syndrome suffer from the cold in peripheral area. Elimination of unpleasant feelings, besides its positive effect, leads to a person's encouragement in the fight against the disease.

• «Soaring, zero gravity» -- special formulas are used, which generate the feeling of soaring, "zero gravity" and "dissolvation" of the body.

Having mastered this exercise one feels reduced pain, less heavy weight, which is characteristic of such patients; their mood and health improve.

• «Target autosuggestion» -- its formulas are defined by definite medical tasks.

They are targeted on developing adequate attitude to the work of implants, normalization of sleep, correction of character deviations, overcome of fears and uneasiness, mobilization of personal resources.

• «Activation» -- is carried out through formulas and concepts, which contribute to the exit from the state of immersion.

It is stressed that a body is charged with energy, force, and it heads to health restoration and further health improvement. The five exercises according to V. Skumin are the most optimal and highly effective means of mental selfregulation, which lead to quick stabilization of mental condition and have a positive influence on self-esteem and medical state. By the whole, inclusion of mental rehabilitation into medical-management programmes eliminates and predicts the progress of psychological adaptation.

Leading role psychotherapies in the treatment Skumin syndrome and does not exclude the application of psycho-pharmacological preparations, although one should remember about the cardiotoxic action of some of them.