Paula what is your Background in Healthcare
My background in healthcare now spans 20 years. I have worked in a variety of healthcare settings. I have been a Registered Nurse since 2010.
I have worked for the Cleveland Clinic, University Hospital, a County jail, a State Mental Health Hospital and 2 Community health facilities dealing with people suffering with drug addictions and many mental health diagnoses among other places.
Now I can add Ketamine nurse to the mix.
What ages of people have you cared for?
The population of people I’ve cared for have ranged from children as young as 8 or 9 and adults that have been 90 years or even older.
What have you seen with Ketamine?
What I’ve seen from ketamine are some amazing results with patients at Ascend.
Well, like chronic pain patients, an example might be CRPS Complex Regional Pain Syndrome as well as patients with other pain related neurologic conditions, I’ve witnessed patients sometimes being brought in not even able to walk and in severe pain and the next time I see them, they tell me they had a month or more having what they call “getting their LIFE BACK”!! I’ve also seen many people with severe depression and terrible anxiety who have not been very successful with medications alone, being able to finally manage to pull themselves out of their depression and anxiety.
Who is, in your opinion, the most successful patients who are getting ketamine or spravato treatments?
The patients who in my opinion get the most improvement are the ones who do the work on themselves.
What do you mean by “Do the work?”
Well, I talk to the patients before and after their ketamine treatments.
I ask them questions about how they are feeling, what’s new in their lives and what they are doing, besides taking medications and ketamine.
I tell them all that ketamine often opens the door to their subconscious minds and these doors are often SLAMMED SHUT !! These doors can be shut for months or years.
I tell them, now it’s up to you to do the work once the doors get opened.
You see, people may have had a very traumatic event or many events in their lives that cause them to go on a continuous spiral or loop of intrusive thoughts and feelings, in turn they continue the same behavior patterns.
This often just repeats and repeats pushing the patient further and further down into deep depression and anxiety.
This is why therapy and coaching are so valuable to the patient.
You mentioned therapy and coaching. Why is this so important at the time of ketamine treatment?
People are often so stuck in their patterns of thoughts, behaviors, and emotions that they can’t see their way out of this. (It’s like what you hear, being so close to the situation that you can’t see it.) Talking to another qualified person at this time is often crucial.
What are some of the different kinds of things that cause people to stay in loops?
There are many different things that can cause people to stay in loops of despair.
This could be the environment they are currently in, past or current abuse, medication side effects can be factors as well or not taking the correct medications,sleep problems and even nutrition, habits but most often it’s the thoughts people are thinking.
Do you see a lot of people with traumas?
Many people have had traumas and often they may not be in the healthiest of relationships. Most, if not all people who suffer from depression and anxiety have intrusive thoughts that are negative and too often self-loathing or bad images of themselves. People also live in fear of the worst possible outcomes.
What would you say is the difference between therapy and nurse coaching?
Therapists are wonderful very insightful and helpful. The difference is where the focus is, primarily a therapist focuses on the psychological and emotional aspects of people’s care along with the collaboration with other healthcare personnel.
Nurses address both the physical, the psychological and emotional aspects in a more holistic approach to a patient’s well-being.
Nurses collaborate with therapists, medical doctors, psychiatrists, social workers, pharmacists, and others and look at the whole person, Body, Mind, Emotional State and even at times Spiritual.
What kind of Education do you have?
I graduated with an Associate’s Degree in Science
And have completed courses in Integrative Health, Brain Health and Energy Medicine and even Legal Nurse Consultant
My work as a Registered Nurse has taken me to major hospitals like University Hospital and Cleveland Clinic Both in medical units and Psychiatric units.
I have worked with patients who suffer from many different mental health disorders, including those withDual diagnosis, memory care and addictions.
My specialty for more than 15 years has been in psychiatry with a special focus in Brain health, Integrative Health, Functional Medicine, and otherAlternative medicines. These experiences have given me the opportunities to work with thousands of patients, all with unique healthcare experiences and conditions.
So, would you say you’re the go between for the patients and the physicians?
Yes indeed, and the patient advocate, pharmacy checker, medication side effect examiner and I my jobs always have me as the person behind the scenes, looking for any potential problems based on a patient’s past medical history as well as any current problem they may be having.
You mentioned Neuroscience to me before we came on camera.
Can you tell our audience a little information about the latest findings in this field?
Yes. I feel this is really important for people to hear and understand this.
Neuroscience is the study that explores the structure, function, and development of diseases of the nervous system. This field of study investigates the mechanisms that underlie our behaviors, thoughts, emotions, memory, and learning, as well as neurological disorders. (Relating back to our pain patients that are being helped so much by ketamine)
There is mounting evidence including possibly thousands of brain scans, that prove that the brain makes new neural pathways due to our thoughts, behaviors, and emotional responses. The structural changes are called neuroplasticity.
Is this what happens when people have depression and anxiety?
Yes. I would believe in most cases this is what happens and this makes it so difficult for people to change and get out of these kinds of problems. But there is a positive here….
The great thing about this is that the changes we make to the negative like in cases of depression and anxiety can be reversed the same exact way that these pathways were created.
Brain scans prove this by the changes that come about in the increase of gray matter and density to our brains.
What would be ways that people could change their Brains to the positive?
Examples would be mindfulness of our thoughts (awareness of just what we are thinking) If we are aware of our thoughts, we have a much better shot at changing the stories our minds are telling us. (I love to suggest that people replace thoughts of gratefulness into their minds throughout the day, starting first thing in the morning, even before they get out of bed and do this as the last thing they do before they go to sleep.
Grateful thoughts throughout one’s day make little room for thoughts of doom and gloom. Practices like this can decrease our stress and depression. Another approach is to change our emotional responses to our outside environment (an example would be, let’s say you do something that triggers a bad feeling in me, ( if I’m mindful of the particular thing that triggered me, I can pause and examine the thought and or feeling it provoked in me, and pause long enough to ask myself, why this is causing such a reaction within me. Yet another example is, behavior changes (This is a great example where neuroscience comes in. (Let’s say I start going out to eat most evenings after work and each night I have a cocktail at dinner……and I do this for a couple of months, sometimes it’s one and sometimes it’s two drinks. For some people this could be ok for a while but for many, this kind of behavior can cause your brain to start to prompt you. When I say prompt you, I mean, when the time is close to 5 o’clock your brain may start asking you the question of what are you going to eat?? Next the brain may ask, what kind of drink do you feel like having tonight?? This is how people can begin to get into trouble…. Then there are important factors like getting proper sleep which is crucial to our brains. And for so many people this is a big one and that is eating better, which we could have a whole other talk about with our current world of processed foods.
There is also continued learning, which is so beneficial in keeping and restoring brain function and neural pathways. And lastly, let’s not forget about our failing societies’ social interactions, which are so important for our sense of belonging, love, support and so many other reasons. These are the kinds of things that help people to get out of the loops I talked about earlier and many more.
These all sound like great tips for combating Depression and Anxiety.
I think that reminding patients who are struggling with these problems and solutions really do help people to climb out of their tough spots.
Now you will soon be leaving us at Ascend to start your own business, Creative Calm Coaching…. Can you tell our audience about your plans for your business?
Well Creative Calm Coaching has been a driving thought in my mind for a while now. I know from working here especially, that this is a sound business idea that is truly needed by people.
Just like what we explained in this past half hour, our brains are programmed, mainly by our past experiences and our current thoughts, emotions, and behaviors.
I have spent the past 20 years watching my patients go on a hamster wheel of medications and a revolving door out of the hospital just to return 6 months or a year later. Many of my patients never truly got better, at least not for very long.
I know that this does not have to happen! Many people can get better, and many can do this without medications.
I want to give my patients tools for better all-aroundhealth and well-being starting with the mind.
A holistic approach- is a approach to healthcare that considers the whole person-body,mind,spirit and emotions along with western medicine and possibly other alternative medicines. This kind of approach aims to treat the person and not just the symptoms.
I will meet with a client and listen to their concerns and needs and together we will look at options and routes they may like to try to see if they can get to a better place.
“I give all the decisions and power to the client.”
I feel real change is only made when a client decides to take control of their own treatment.
I listen and suggest to clients’ what kinds of questions may be helpful to ask their doctor and explain why this may be helpful.
Often patients don’t know what to ask.
I may suggest certain kinds of tests they could ask for and why. Maybe we could look at the medications they are on to see if any problems could be coming from that area.
We may want to discuss nutrition and discuss the things I have come to know in this area that plays a role in mental and physical well-being. If a patient is having relationship issues or emotional issues, we can discuss them as well if they would like to talk about those. I can share practices that I have used in the past and ones I use every day that keep me free from anxiety and depression and more at peace.
I am also a painter as well, which is one of my little niches in keeping myself mindful. I do plan on incorporating my business involving the Art’s since I have found so much benefit in working with art as a way to keep myself in a calm state of mind.
My hope is to also bring more of this kind of information to Ascend patients in the future and maybe even have a few art classes as well.
The public can find many of my Art pieces at Ascend for sale at reasonable prices if they are interested.
Thank you, Paula, this has been an exciting and informative podcast. People can reach Paula at [email protected] or creativecalmcoaching.com.
So that was the script for our show with Nurse Paula: Here’s the actual transcript in case you’d like to compare the differences.
Hello and welcome to the Ascend Health show I’m Nick Angelis I’m a nurse anesthetist and one of the owners of Ascend Health Center and I’m here today with Paula Welsh who is our nurse at Ascend Health Center now normally I don’t bring people who work with me on the show because it’s harder for me to be normal and professional with people I work with since I insist on having a good time every day that I work but we made an exception so how are you today Paula I’m good Nick and thanks for bringing me yeah Paula is an artist she has about 20 years experience as a nurse and we’re going to talk about all sorts of things today cuz Paula actually took notes that’s not how this show normally goes normally we just talk and see what comes out of our mouths for 30 minutes but Paula came here prepared very impressive well we’ll see how it goes it’ll be fun either way you know I’ve never had a show that’s been a disaster but if that were to happen today that’s some good TV so you know yes it would be hope for the worst or the best or maybe a combination of them but why don’t we start by talking about your experience cuz you said you’ve been a nurse since 2010 right yes nurse since 2010 but I started in healthc care in 2004 okay was that when you were a tech at Lutheran Hospital Tech at Lutheran Hospital for seven years uh worked on all the floors just about at at Lutheran uh a lot of psychiatric floors as well and you know this is maybe I should bring people who work with me more often because the advantage is I actually know you as opposed to most of the guest I’m like hi my name is Nick let’s talk in front of a camera for half an hour and see how it goes so what what was that experence like because I was a nurse Tech too uh but I was a terrible nurse Tech I’ll admit that openly I had no common sense a lot of books smarts didn’t know what to do with patients had no idea how to keep myself useful but were you any better than I was uh probably yeah I know no I was a good Nur nurse Tech um I really enjoyed my patience I really enjoyed working on all the different floors at Lutheran I love that hospital right I really did and even though we’re only you know talking a few years back I feel that Healthcare has accelerate and changed so much just in the last 20 years yeah that’s putting it mildly I mean not that we weren’t that nurses weren’t always busy uh but it wasn’t quite the Breakneck Pace where almost every nurse I talk to now is saying things like I need to become an NP I need to become a nurse and neist I need to get off of this floor yes yes it’s it has changed quite a bit in in the last 20 years wow yeah so what was it about the Psychiatry that really Drew you once you started uh working in those areas I loved psych um probably right through right right from nursing school okay um I was one of the students that uh the other students would push in the front of the class you know and push you know through the door because they were afraid to go on the psychiatric units a lot of times wow that is actually to my experience where I was like no I like these people this is great and everyone else is like oh I this isn’t really the specialty for me right right people find their comfort spots yeah okay and how I know we already started talking about but how is it different now do you think then when you first started how is psych different yeah psychiatry psychiatry is different in a lot of ways um I don’t I I I don’t know I don’t feel that uh patients are being uh attended to as well nowadays by the way this is going to happen to initial I told Paulo like let’s be professional for like 3 or 4 minutes then just let it rip let us know all your opinions it’s it’s Community TV there’s no sense say we’re going to tell it like it is right I mean I mean patients aren’t listened to I mean let’s just you know be real about it 10 minutes in 10 minutes you know and that’s all they have right so and I some of it has to do with the time because no matter how great an expert is if you have a 5 minute snapshot it it’s sort of like a you know I’ve hired a lot of people for a send Health Center and usually there’s a second or third interview and sometimes a second interview I’m like this is a much different person than the one I met before right so if you’re having a bad day and you go in for your psych appointment you might end up with a totally different diagnosis yes I mean you have to listen to the patient you have to actually listen to the patient to know what their problem is and know how to help them mhm and the other thing with taking time and I I know it’s not time it to go into Segways and tangents but I’m sorry this is who I am as a person Paula uh you are starting the creative calm coaching and that’s one of the ideas that sometimes you need five minutes of a specialist and that’s all you can get but other times you just need someone to listen and you need that more thorough approach to really see what’s going on right yes and and with uh creative calm coaching um my my plan is to be able to sit down with a client and listen to them hear about what their problems are and not just focus on uh a medication to fix the problem right um there’s a there’s a lot involved in uh helping a patient with their care to truly help them with their care right or sometimes a medication can be a bridge but with the knowledge that okay this isn’t the end result that here’s your proac hope you’re better it’s more of like okay maybe you need something right now so that we can start controlling somebody these behaviors or get a hold on this but then let’s move past it which can also be challenging Psychiatry because a lot of these meds aren’t meant to be like take this for a month get yourself together and get off of it it can be very challenging to get off of mental health medications right absolutely I I don’t suggest that anybody get off of mental Health medications abruptly M you know never yeah we usually do have some sort of uh disclaimer on this show and not as much of like don’t listen to us and don’t listen to our medical advice cuz then why are you watching this if you’re not interested in what we have to say but more of uh you should really talk to your doctor before you implement any of the more detailed things that we talk about today right right and and really a more holistic approach with patients I feel is needed um you know there’s there’s different aspects of of patient care uh there’s you know the the physical part and there’s the emotional part um there’s a psychological part um there’s all kinds of different different things that patients need you know they may have nutrition problems they may have problems at home they may have problems uh just dealing with uh relationships in general um so there’s different pieces and parts uh that come along with the patient and you have to really dig into all of these parts in order to find out what the true problem is Right absolutely yeah I was talking to someone the other day and uh they had a different religion now then their parents and I was like well this isn’t a medication issue this is a spiritual issue right there’s only a spiritual answer for this problem it’s not something that we can you know paper on some medication and oh your everything’s fine now right so until you know what the actual problem is you actually disguise the problem it’ll be like taking your uh dog to the vet and giving him some ketamine and say okay figure out what’s wrong with them which is a nice segue into the topic of ketamine ketamine yes yes but to finish that thought a lot of times when we take the wrong action or really too much action to help our health we simply disguise finding the root cause of it and it makes it more difficult absolutely you know we we then have to backtrack to find out what was the original issue that we started to work on before we started trying all these different things to just disguise and mask what was really going on right and then you’ve got patients that have been on 20 different medications and they still have the same problem right you know and and this is a terrible analogy but it’s sort of I might have use it before on the show so forgive me for anyone who’s watched more than one of these which probably isn’t too many people honestly but if you’re dating somebody who’s terrible you’re actually worse off than a single person because you have to break up with them like go through that breakup then you’re single then you have to find the right person it’s actually more of an ordeal than just being single and trying to find somebody so I would agree with that too so that’s a little bit how we find some medic some of these patients that it’s not only that you have anxiety or depression it’s like you’re in a bad relationship this lexipro isn’t helping you or this boost part was not the right dose or whatnot no it’s not the Lexapro it’s the boyfriend so that’s that’s our Central thought for today it’s not the Lexapro it’s the boyfriend or the girlfriend right but that’s fair like sometimes if you’re in a relationship and it’s only working out because of the uh high does medications you need maybe it’s time to rethink some of your relationships right just dropping wisdom here at a send Health Center on our show so I started talking about ketamine in reference to dogs out of that now we’ll transition to ketamine in our Clinic as a professional medical intervention uh what have you seen with the ketamine infusions that we do at asend well I’ve seen great things with uh ketamine um I I’ve I’ve been at Asen now for about almost a year year and a half yeah um and I really seen great things um which is is so refreshing for me um coming from all these different places that I’ve worked uh Cleveland Clinic uh I’ve worked for the state uh in mental health I’ve worked for a couple of community-based places um dealing with patients with addictions and traumas um a whole variety of places and honestly I’ve seen a lot of uh patients that really weren’t getting help and it was just a revolving door I would see the same patient come back in six months and you know they’re you know just the same or they’re worse off than they were when I saw them the first time so coming to ascend and seeing the patients being treated with ketamine was really refreshing for me because I was actually seeing patients get better um I see patients get better with pain uh when they have problems uh such as the CRPS RPS um chronic regional pain syndrome uh they come in sometimes they’re in wheelchairs sometimes they can’t walk and then the next time I see them uh a month or so later um it’s like they have gotten their life back and they they tell me that they were able to do things that they weren’t able to do and I also see patients getting a lot of help with the depression and anxiety severe depression severe anxiety in a lot of in a lot of cases um so that’s been really good yeah and to be clear it’s not every patient that like oh this is a perfect treatment for you it is still a minority of our patients but it’s also the ones that we deal with directly since me as a nurse nesus and you as a nurse we’ve made a good team uh helping these patients through the process yes and and that’s what I’ve uh done at Ascend uh basically with every patient that I have um I I sit with them I sit with them more than you I think absolutely yeah I sit with them personalities are different I’m a little bit more nonsense like here’s your medicine I’ll talk to you when you’re done yeah but not me not me I walk in and I’m like okay tell me about your life what’s going on you know um you know what’s new in your life what are you doing differently um how are you working on yourself uh what are you doing besides taking medications and besides doing ketamine I want to know I want to know how they’re changing and that’s how I can tell who is going to get better and who is not going to get better it’s the patients that are actually working on themselves right none of these treatments unfortunately are a quick fix no matter how much hype there is about medical marijuana or ketamine or transrenal magnetic stimulation all of it is just a tool along with other things that you’re doing now there is one caveat that I often say oh you need to do more than just take a pill because it takes no effort on your part I do believe that in Psychiatry it’s a little different because most of these pills have side effects so it’s not the same as in well I’m going to take this cholesterol pill it’s not going to affect anything now I can eat the way I want like I do feel that there is a sacrifice because of those side effects often in Psychiatry um so it’s not simply that people are taking the easy way out because a lot of times in life uh we see the opposite issue where people feel they have to deserve their health so they’re doing all these difficult things that they may not really need to do you know CrossFit at 6:00 a.m. rolling huge tires across an empty parking lot it’s like well that’s Noble but are you trying to like earn your way to health are you saying I only deserve to be healthy if I will do all these things so there is a balance there too and sometimes we’ll do that I do this all the time actually where I tell a patient hey you know what you could be 10% better if you do this if you pay for that if you do this treatment and then I say but honestly I don’t think it’s worth it cuz that sounds like a lot of effort and and it’s really nice for these patients not to be in survival mode to be like you know what I could improve even more and I’m not going to like I maybe it’s just me in the way my personality is but it’s nice to know that sometimes we don’t have to take it to the hilt and do everything just right and then will earn or deserve like a healthy lifestyle right yes and and it’s a lot of pieces and parts I mean you really have to be working on your thoughts you have to look at your habits you have to look at your behavior um It’s a combination you have to look at the your nutrition especially um with all the process foods that are out there right now um and you have to look at your social interactions I mean we really need to have that sense of belonging um you know put your cell phone down stop texting make a phone call right go knock on somebody’s door talk to your neighbor yeah it’s really important I was listening to an Audi book on on the way here from an Indonesian missionary and he said there were uh two men on a deserted island they both owned three miles of a deserted Coastline and they built their houses right next to each other he was like why’d you do that they’re like why not why not there’s actually no word for privacy in the Indonesian language like for them even the concept of being alone and it was more a book about faith but it’s a collectivist culture where there’s no concept of like deciding something on your own and and are they happier people they’re probably much happier than a lot of Americans right so a lot of times we say this is my health this is my problem I need to be very private about my health and I’ll work through it and these are issues that humans weren’t built to to solve on their own you can’t live in isolation and say well here’s all the things I can do by myself to make myself better it does take a community for many disorders especially when we’re talking about social anxieties uh you know since Co we’ve seen a lot more of depression anxiety as people found their coping mechanisms taken away from them abruptly and they still haven’t found a way back into like a normal pattern right and then people wonder why they’re lonely mhm so what is the toolkit that you will use with creative calm coaching because we’ve already started talking a lot about nutrition and way people can eat right cuz that’s a thing too there there are some Services where uh and I’ve never bought into any of them where it’s just okay people telling you what you already know but you’re paying somebody for the basically like you’re paying someone to be your mom but in your case you’re saying well look I’ve had this expertise from working with ketamine from these 20 years of experience so what’s different about it or how do you help motivate people well one thing is I I believe that if people have to know and understand their problem first of all like Neuroscience sure people don’t know what Neuroscience is um and neuros science um it deals with knowing the the function and the behaviors and your emotional state and there’s clear science on brain scans with gray matter and the density of the brain um that shows that neurop neuroplasticity takes place basically everything that you’re doing whether it’s let’s say towards the negative you’re actually training your brain towards the negative um but you can train your brain towards being positive by just the opposite action of what you’re doing and if people understand the idea of what is happening with the brain um and and they understand it better than what I explained it um then they can at least have an idea that it is possible to change and they can do this with changing their thoughts um to the positive and that’s something that I stress with the patients every day is you know what are you grateful for and I try and get the patients to um tell me every day that I see them what are you grateful for um I I do it first thing in the morning even before I get out of bed I ask myself what am I great ful for and I do it last thing before I go to sleep at night what am I grateful for if you put these positive thoughts inside of your head all day long instead of the negative there’s no room for that Doom and Gloom right but you but you have to be consistent about this and you know and it actually works it’s proven science it will work um so those are things that I try and teach patients um I also look at you know like I said before the holistic part I’m looking at your physical health I’m looking at your mental health I’m looking and to see what are your relationships like where what about your your environment that you’re living in um I mean there’s so many different factors and people’s happiness and peace um you have to find your peace if you can’t find your peace what do you have right and sometimes it is difficult too you have to almost choose your heart like well this is a difficult relationship and sometimes it is almost the uh American Western way of saying well let’s just cut them off they’re not serving me but that’s easy like in life you will have struggle if it’s not now it’ll be later and a lot of times when we try to avoid struggle or we avoid hardship just pursuing happiness we’ll never find it because we’re navigating around everything and never accomplishing anything that and because most relationships actually get better through conflict uh you know there there’s a lot of research into marital relationships where it’s like if you continue to avoid what problems you have you will lose an opportunity to grow because it’s what you’re saying about habits that you can change the neuroplasticity of the brain with ketamine with brain derived neurotropic Factor adding more synapses that sounds all very technical and exciting but none of that does anything for anyone unless they use that opportunity to form better habits with their brain right so and it also makes it more at home because you people often ask for the latest and greatest medications in Psychiatry but none of that really matters unless you start forming habits that will help your brain to continue to be happy I’m not happy in a gleeful okay I need my next hit of some medication but happy in a resilient if you have a bad day you know that well maybe tomorrow will be better that sort of Happiness absolutely maybe Joy would actually be a better uh word to use than happiness something that regardless of your current situation there’s still an underlying understanding that there’s Hope For Tomorrow absolutely yes yes and then and with creative calm um I also do art and I I mentioned or you mentioned that before I have some of my artwork uh at Nick’s uh place of business yeah absolutely just come on by and wander in and it’s we might ask you who you are and what you’re doing here it is for sale um at reasonable prices and um I’m planning on doing some art classes uh and some workshops um workshops on anxiety and happiness and uh whatever else uh Nick would like to you know have taught to some of the patients so that’s part of my plan um yeah I plan on meeting people oneon-one uh talking with them uh trying to see if there’s anything that I can help navigate with them through the Health Care System uh yeah I mean people people have these problems and I’m hearing it all the time from patients that they’re they’re going doctor to doctor to doctor and they still have the same problems right but maybe there’s something that I could do even you know looking at their situation giving them different questions that they could be asking their doctor for help right um different tests that maybe I could suggest that they ask their doctor doctor for or even focusing on what’s the priority like what do we need to fix and by fixing this issue then it’ll be a ripple effect where a lot of my other problems will go away right I mean we do that with pain at us end when we first started we really focused on almost being an alternative to pain management and now it’s almost like a secondary thing like well you know what if we get your mind in a better place a lot of this pain will take care of itself so let’s not focus on the pain itself and there’s plenty of resources out there too like tame the Beast I think that’s on YouTube uh to let people realize that sometimes when you Fus Focus completely on the problem you’re actually creating more issues it’s more of like okay how can I be more positive and then go from there now of course as we’ve said a lot of times patients will say well no uh I’ve tried seven meds and failed I don’t think being happier or being a positive mindset person is really going to make much of a difference but again each it’s like a puzzle so each little piece fits in a different area and uh that’s how people can grow and actually make changes long lasting in their health yeah yes absolutely and I did have one more question because we’re almost out of time but this is always my favorite question to ask because I’m a devil’s advocate type of person but who would not be a good candidate for you cuz a lot of the times we have shows and by the end of it it’s almost like when you watch those documentaries on Netflix and you start believing absolutely everything that the documentary says so as a caveat is there a certain type of patient or a certain step in someone’s Wellness process where they wouldn’t be a good candidate for like creative calm coaching well uh you know you know I’ve thought thought about this and I think it depends on the individual and I would be really upfront with someone if I thought that I was not the person that could help them but I would hopefully be able to partner I’m hoping to be able to partner with some people um that I might be able to refer people to right well that’s that’s and that is what’s wrong with our health care System among many other things is okay hit a dead end now what do I do so willingness for providers to say you know what I’m not an expert at that but here’s somebody who is you know I could help you a little bit but here’s somebody who’d be even more helpful for you right sometimes you can take them take people just so far and and then you’re out of your your field of expertise absolutely or even with a ketamine infusions most clinics it’s a lifelong okay you start ketamine this is working for you let’s do it forever and usually at a end we’re like well okay you’ve done a whole series of six infusions what’s next do you necessarily need to continue this or has this been enough of a jump start that now we can just continue with therapy or talking to Paulo or whatever the next step might be so it’s always good to give options and I think that’s what you’re saying you’re going to do with this new business is yes let’s look at these options let’s see if we can creatively use that creative part of our brain and offset some of these negative behaviors or these intrusive thoughts right because you know a lot of times we think of it uh I just bought some more coloring books from Dollar Tree cuz we only spend the for our patients at a send Health Center and the patient was like wait what’s this I like it’s a coloring book if you’re finishing your spado because you have to stand our clinic for 2 hours don’t start Doom scrolling on your phone do some coloring and sometimes unlocking those creative or childish parts of our brains and not really me cuz that part is always unlocked for me but that actually does help healing in ways that people are surprised about yes and it and it’s amazing because I think we all have talents uh we all have little things that we’re good at besides our jobs right and you know whether it’s playing piano or it’s it’s doing arts or it’s gardening or it’s cooking we all have these talents and those talents keep us in the present moment absolutely and it’s just like meditating yeah which I’m also pushing on patience all the time well there we go well thanks for joining us today well thank you been a great show and we’ll see you all next time