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Its Where I Am focuses on the various mental health struggles that people all around the world face every day. Each episode covers a different facet of mental health with a new special guest. It's Where I Am airs on 91.5 Jazz & More every second Saturday of the month.
Unknown Speaker 0:00
This is a k u and v studios original program.
Unknown Speaker 0:03
You're listening to special programming brought to you by it's where I am.com. The content of this program does not reflect the views or opinions of 91.5 Jazz and more University of Nevada, Las Vegas or the Board of Regents, the Nevada System of Higher Education.
Unknown Speaker 0:44
Good morning Las Vegas, it's Dr. G on it's where I am airing every Saturday at 7:30am on K u and v 91.5. FM. I'm Dr. David JENICE, clinical and public relations director for great minds counseling and Wellness Center. And it's a pleasure for me to be guest hosting on behalf of Zondra pol lard. So I think we have a great show today. And and part of my goal in hosting this show is really bringing to its listeners resources and interventions that potentially can enhance the life of an individual or a family. And so today's guest I'm really excited to talk about what this person does and what she oversees and how she's impacting the lives of so many people up in northern Nevada. So it's my friend and colleague Shawna Houston, who is a registered nurse, and she currently is the Assistant Clinical Director and Director of compliance and risk management. So she received some pretty high recognitions within the past year that I think is noteworthy to share with all of you. So Miss Hewson received outstanding preceptor of the Year from the University of Nevada Reno Orvis School of net of nursing. Outstanding, that's exceptional. But But I'm not done yet. She also received the People's Choice Award for Chief Nursing Officer of the Year for the state of Nevada, from the Nevada Nurses Association. And she received this award by US Senator Catherine Cortez maestro, incredible. Hi, Shawna, how you doing today?
Unknown Speaker 2:53
Hi, that was a beautiful introduction. Well, you for daily pet.
Unknown Speaker 2:59
I mean, you know, well deserved and I know how much work went in to be recognized for those two very special recognitions. So congratulations again. You deserve it. You work hard and you're good person and the effort and the heart that I have seen you firsthand just just emanates from you and it's catchy and you inspire others to want to do good work and and help help people so okay. The whole reason why I asked you to be on it's where I am is because of your current role though. As Assistant Clinical Director at radiance ketamine clinic, you know, Shana, ketamine is a drug that I'm really not too familiar with. And I was so pleased to hear from you, though, that it's been FDA approved, and that there's been a lot of research happening around the utilization of this drug, and helping individuals that have some challenges or suffer with specific symptoms related to mental health. So I'm eager to hear more about radiants ketamine clinic and all that you do up north and how you're helping so many community members up north.
Unknown Speaker 4:27
Yeah, thank you so much. And while ketamine in and of itself has been around for actually a very long time, it's pretty commonly used throughout the Vietnam War, the Korean War as an analgesic. It's been used in surgical procedures for quite some time, but only pretty recently is within 2020 was the first initial clinical studies when they were it was Yale University that started looking at and studying ketamine and they essentially discovered that there was an anti depressive effects. And going from that point forward, it's been pretty, pretty amazing in such a short time, the synergy of what's been happening for treatment resistant depression, depressive symptoms with suicidal ideation, but also treats certain regional pain syndromes, as well. And, you know, the, the difference, one of its unique properties of it is that there's a element of dissociation that can occur during your treatments. And what that really does for people, you know, oftentimes, when we suffer from anxiety or depression, or a traumatic space, we typically have a very intense somatic reaction, which means our body prevents us sometimes from being able to visit that space of harm. And so we don't give our anxiety a lot of credit, when it's actually trying to be on our team. It's just like a hyper vigilant helicopter parent for our peace in when you're able to get into an experience where you have a disassociated state, essentially, your body doesn't kick in and prevent you from revisiting things that you might need to have a rise in order to resolve them. But additionally, we're seeing amazing things with the neuroplasticity. And the BDNF, brain derived neurotrophic factor that we know. And it's one of our magical brain chemistry is that we know is increased when we have ketamine, as well as our glutamate is increased. And so we're seeing huge progress with people that feel like they're stuck in a rut, essentially, that mental pathway that we're treading over and over again, against why it probably also helps with OCD symptoms. But it's been one of the most beautiful things I've seen, and one of the first new developments in mental health treatment in quite some time. So I'm really, really proud of what we're doing here, because it's been amazing. So
Unknown Speaker 7:15
Shauna, you you have identified the efficacy for some very specific symptomology. So I, you know, I've heard how it's being treated to help individuals that, you know, have been stuck and managing potentially depression, post traumatic stress symptoms, their anxiety, you mentioned, OCD, as well as some no nerve pain, you know, so, so, for these, can you help me understand, like, is it a pill that individuals take? Like, how is the ketamine you know, ingested, I guess, by the individual? And, you know, can you explain to our listeners, you know, just the process, so what would they anticipate if they came into your clinic, which is radiants, ketamine clinic? What, what would be the first steps? Can you kind of walk through what a patient goes through?
Unknown Speaker 8:19
Absolutely. salutely. So, initially, it's really important that your mental health care provider is on board with referring you for ketamine treatment and ensuring it's appropriate for you. And so very first thing we do is everyone that we see has a referral from a psychiatrist and nurse practitioner, a PAC with P, whoever prescribes your medication, typically, because one of the facets of what we're doing is for treatment resistant depression, which is typically defined as you have tried medication, and it hasn't worked well for you. So once you receive a referral, we reach out to you. And that's when we go through and ensure that there's no contraindications for it to be the right thing for you.
Unknown Speaker 9:02
So can you identify I'm sorry to interrupt you could Shana, can you identify what would be some of those contra indications? Just so that, you know, potential users of of this intervention could maybe potentially think about?
Unknown Speaker 9:22
Absolutely. And it's not even necessarily that we know these things will be negative, but because of the genesis of this new treatment, there's just areas that haven't been studied appropriately that we can say definitively would be good or bad. So an example anybody that has a history of psychosis or has significant issues with schizophrenia, do you think they can have it predictable results when you're on a hallucinogenic such as a psychedelic is ketamine? Those are some of the areas that are caused concern and there are some studies To indicate that my patients with bipolar disorder has been in induced state of mania with ketamine use. So we also have clearance through your provider before we will see patients with bipolar disorder. Medically, there's a few contraindications as well. One of which being uncontrolled hypertension. Because at 40 minutes into your treatment, you can have a really minimal spiking blood pressure. That is a typical into, you know, typical side effects of the ketamine empirically, I don't see it very often, but it can happen. So anybody with uncontrolled blood pressure is someone we shy away from history of aneurysms within the body for the same reason. Hypertension can can obviously be a difficult thing there for anything that can potentially have a hemorrhagic effect or bleeding effect. And of course, if you're allergic to get Amin, and those are essentially the only major contraindications. There's a few medical conditions that we have clearance from a provider for since such as interstitial cystitis, glaucoma. But those do not by any means negate your ability to have treatment. There's just some extra precautions taken if you have a history of any of those of those issues. And additionally, like dementia is a concern. Because with neurocognitive impairment, it's an ship sure what the effect will be. So we prefer a clearance by a neurologist before we'll see people that have those conditions.
Unknown Speaker 11:36
So I really like though, what your clinic is doing Shana in clearing the patients medically first, to really set the individual up for highest success and utilizing this intervention to help decrease and manage an individual's mental health symptoms. Shanna, you mentioned that, you know, the typical candidate for this intervention is an individual who has been treatment resistant, utilizing other psychotropic medications. Is there another type of patient that could potentially benefit from coming into your clinic and exploring if this is a good intervention for them?
Unknown Speaker 12:29
Well, absolutely, and there's three different opportunities of what we do treatment wise. So one, we do intravenous IV sessions. And those are typically very effective, they respond more quickly if you're in an acute state of depression, if you're having repetitive OCD, ritual like behaviors. One of the most astounding beautiful things that we have witnessed here is what this is doing for our veterans and our first responders. We have quite a few members of law enforcement as well as military that have had tremendous benefits related to their PTSD syndrome. We've had with with chronic regional pain, which is very specified type of pain. There's evidence that this the longer ketamine sessions have been beautiful in assisting those folks. And then Currently, there's research coming out of Yale University, again, in relation to ketamine therapy being FDA approved for Parkinson's symptoms. So, really, there's so many opportunities for what's happening because it is so new, that are being discovered as we anonyme the plan for who does who will benefit from this. And it's really been all all walks of life have come to the door, most people have never engaged in any kind of substances, they may have just been at their wit's end. A lot of our patients have literally tried almost every antidepressant known to mankind. Yes. And as we know, with, you know, the study studies, you know, when once you first try an antidepressant, your chance to recovery, is it 70% And then it continues to go down to 30% to 14%, depending on how many medications you've tried. And so the beauty of what's happening here is, you know, now that we're getting enough evidence based research behind what we're doing, we're seeing 33 to 70% improvement in the symptoms and we've got the spravato which is the S ketamine, which is kind of the the new thing that really drew the attention to what ketamine is doing for people. That's covered by all insurances. We accept all insurances here, and that's been absolutely amazing. And that's an intranasal form that self administer. So
Unknown Speaker 15:00
that that is a huge Shana, because you know what I mean? If I was to bring interventions to a community, it's not going to help anybody if the community can't access the intervention. So the fact is that you have, all these medical insurances are credentialing to cover this intervention is allowing people to have access to care. And that's really, really awesome. So, you know, I did write down a note earlier, that ketamine is on the World Health Organization, and it's being viewed as one of the essential medicines and health Hi, oh, yeah, yeah. So that's incredible. That's incredible. And so one piece of information that I caught my attention Shana, when you were speaking, I wrote down a note that you are seeing significant improvement and efficacy and managing the mental health symptoms for PTSD, in the military, law enforcement and in our first responders. And, and so I'm hoping because, you know, this is really fascinating and interesting to me, because I'm a provider of supporting individuals who experience trauma, how has the use of ketamine help these individuals?
Unknown Speaker 16:38
Well, often times, I mean, there's also I have to say, an incredible acknowledgement of the team we have in place here and the training that they have in intervention. And because additionally to our sessions, we have ketamine assisted therapists are available, as well, as you know, some of our staff members are ex military. And so being ensuring the report is appropriate for a person. And during some of these experiences, I might not have a familiarity with history really powerful in the sessions. But typically, as I was mentioning, with the somatic response before, when you take away your body, stopping you from the anxiety inducing pain of what you're what's been playing over and over again, in your mind, you're allowed to see it for what it is. And often the power of some of those events can be negated by not having that intense and anxious reaction to them. Yes. And you're there's also an element of the altruistic sense, because you experience something. There's a spiritual element to a psychedelic. And there's some mystery in the components of how these things work. It's very multifaceted, the theories behind how this therapy works. We know it safety parameters, we know that it's a very incredibly safe drug has it's been around for a very long time. But we don't know exactly why these people have these beautiful experiences that connect them to a higher self, we know that the neuroplasticity changes, we know that you're creating a new neural pathway. And in doing so that creates new territory. So, you know, when we've been in the states of depression, we're treading on the same trail over and over again. And it's just we're so tired, and we want so badly to feel differently. But what the ketamine typically does is you get to go off trail with a machete you are you are blazing the trail, and creating a new one in in being able to kind of push pause on something that you're just ruminating on. And that is really where the breakthroughs come. And really getting people in touch with going beyond that secondary emotion, which often I've seen, not always obviously, but the PTSD factor with our vets. And our first responders, you know, can be anger, because that's a lot more empowering than feeling sad, or scared or
Unknown Speaker 19:09
overwhelmed. Absolutely, yeah, we will
Unknown Speaker 19:12
go with something that gives us more control, right? So we like to, you know, those those factors, you know, we're able to really learn from that space and know what's really behind this space. And it's, it's such a safe environment to be able to express that. And I wanted to also emphasize, in addition to the safety parameter we're monitoring you at all times. So we're your vitals are being read throughout your entire visit, you're on camera, you have a comfort light, it's not an emergency light, it's a hey, I need someone in here with me, will typically stay with people take them through breathwork you know, guide them through those really significant moments in their session space. So I think there's a lot of factors about what really contributes to the breakthrough and I I can't. It's been the most morally congruent I've ever felt in my career in mental health in what we're doing and what the results have been for people. Well,
Unknown Speaker 20:09
and I know you for on a personal level and for you to make such a strong statement speaks to me because you know, the many conversations about the implementation of mental health services you and I have gate engaged in, often, and I know the passion and the heart that you have and wanting to help people. And so, you know, I have some more questions. So Shawn, I'm trying in my head, and I'm sure this would be helpful to to our listeners. So I believe you said there's three ways to receive this ketamine intervention, one is through IV, what are the other two ways? I mean, what are our options?
Unknown Speaker 20:56
Well, I'd like to say there is other ways but this is what we offer, because there is options that people have been exploring at home. That is not what we do here. But in our clinic, we have intravenous which I mentioned, we have intramuscular, and we have spravato, which is s ketamine, one, which is part of the ketamine. So there's ketamine itself is comprised of two isomers. And one alone is the spravato. And then the im and the IV sessions that we have are the full molecule ketamine. And so you can have shot, you can have an intra nasal spray, which is essentially like, if you've ever used a flow neighs, you know, that would be a typical convert of state, and then the intervene years, and there is truckies. There's other ways to receive ketamine that we haven't found that the doses are really appropriate. And we do not, in our practice, have patients have any kind of dual ketamine treatment. So we offer those three options. And it's been beautifully effective for, for those that we treat, oftentimes, people might even start out initially with IV sessions, because it does have a, I mean, there's some studies that that support that long term, the results are the same with the S ketamine, which is the intranasal versus the IV, but what we've seen to be, you know, it's, it's, the efficacy is a little quicker if you want to if you're in a really intense state, and then people typically transition from the IV sessions to the intranasal sessions of the spravato. And the results are very subjective. Some people will continue to come once a week indefinitely. Some people have breakthroughs, right after their induction phase, and end up coming once a month. I have a few IV patients to come once every six months. And it's really, really subjective to what the maintenance of the treatments is. There's a lot of variables there. But those are the primary ways, ways that we, we offer ketamine here at our clinic.
Unknown Speaker 23:02
Well, and I like how you started to kind of explain how you know that each person is treated from an individual perspective, you know, it's really based upon each individual's needs. And so I think that's really important for our listeners to understand that is that, you know, it's not one stop shop so that every person that walks through your doors is receiving the exact same type of treatment, that it's very individualized and that you take that very seriously by, you know, assessing first, the individual's medical comorbidity and making sure that this is the safest and appropriate, least restrictive treatment for a community member. So for me, you know, this is kind of like break breaking medical intervention services, I believe anyways, to treat some mental health disorders. Because, you know, Shawn, I gotta be honest with you. When I first heard that, you know, you were working in a ketamine clinic and you use that word, I was like, what? Isn't that like a street drug or something? You know, Can Can you kind of demystify a little bit more for our listeners in terms of like any beliefs, or myths that we might be holding about ketamine and what it is?
Unknown Speaker 24:33
Well, absolutely, because, you know, to be honest, I had them myself, you know, I was very unfamiliar with ketamine. My first thought was, what like, the horse tranquilizer? Like what is that about? Or, you know, party drug ketamine party drugs, and I myself had never experienced any ketamine in a social setting or anybody, even those that were into this such things I'm exploring This drug. And so there's definitely a lot of stigma there. And then of course, there's gonna be things like bad press and the unfortunate loss of Matthew Perry, who again was not in a controlled clinical situation, and that was not related to his ketamine treatment. But there's definitely some things to demystify here. And what's critical to understand is, everything related to ketamine is dose dependent. And that the goal, you know, you've heard people mentioned, the K hole, you know, and this was when you have too much ketamine and you're in a state that you're so dissociated, you can't move your body, you're still not unsafe. But that is never the goal in a professional clinical setting to be, we want you to be able to retain the insights that you experienced during your session, and we want you to stay awake, because ultimately, it is an analgesic. You know, it's used in surgical procedures. And, you know, it's important to understand that a lot of the myths surrounding the ketamine are really coming from a place of uncontrolled dosing, and inconsistent pharmaceutical, you know, the grade of what you were putting into your body in any circumstances, so critical to what your experience will be. So, to really comfort people in a few things to be known, you know, ketamine is extraordinarily safe in and of itself. It is the same medication that I would use if we were suturing, your four year old child, the half life of the medication for adult, which means how much time does it take to be 50% out of your system, it's two and a half hour. For adults, it's one to two hours and children. So you know, if you double that, it's out of your system, for the most part at that point. So you can have these profound experiences, and then be pretty close to baseline at the end of your session. And in a parameter of casual use, they're typically combining this drug with other drugs, which obviously, we don't do here. So.
Unknown Speaker 27:03
So you know, I'm very interested, as I'm sure many of our listeners are, as well Shana about this intervention. And so if our listeners were interested in getting in contact with radiants, ketamine clinic to, you know, get more information, how can they get in contact with the clinic,
Unknown Speaker 27:27
for our website, radiants ketamine.com is where you could have been clinic.com, that has quite a bit of information there. And we're updating our website now to reflect some of our new members of our team. And there's a lot of great information there. You can call me at the clinic. And that's 775-432-1006. And then really every staff member is versed in what service we provide here. So really, anyone you speak to you can tell you more about it, and if it's appropriate for you. We have a beautiful team, you know, patient care specialists we have our clinical social worker Grayson is a great resource. I mean, even if you wanted to speak to the medical director, Francisco police, he will speak to you directly. I mean, it's a really open team, and whatever assurance you need to understand what you're coming into here. Everyone here is very excited to prepare you for this next step in your journey at mental health.
Unknown Speaker 28:30
Well, Shawn, I just really wholeheartedly want to thank you for taking time out of your morning to be on it's where I am with me and really talking about I think this this breakthrough intervention and helping people manage mental health symptoms. This is Dr. David Jenness, clinical director for great minds counseling and Wellness Center, and I'm on it's where I am. Until next time, see you then
Transcribed by https://otter.ai