Dr. Louwers from Reset Medical & Wellness Center talks to our CRNA about nerve blocks for PTSD. They discuss how trauma affects every organ system and how to reset the nervous system with interventions like stellate ganglion nerve blocks, ketamine infusions, and Transcranial Magnetic Stimulation. The transcript is also below, but they discussed how their training in anesthesia and procedures help them to safely find the on/off switches to find balance in the body.

Hello and welcome to the Ascend Health Show I’m Nick Angelis I’m one of the owners of Ascend Health Center and your host and today I have Dr. Louwers with me from the Reset Center and we might have a third guest at some point so there’s always a chance of a mystery secret guest which is really exciting for me!

Excellent thanks for having me on Nick!

Yeah absolutely so today I want to get right to it when I started my Clinic I thought you know what I should really do stellate ganglion blocks for PTSD and then I realized, well Ascend Health Center is a blend of Psychiatry and counseling and me as a nurse anesthetist and doing nerve blocks was a little bit too far away from Psychiatry for it to make sense for our Center, but in these last 5 years I’ve been searching for someone else who does it and now I found you so why don’t you tell us a little bit about the neurological reset that you all do there.

Sure, sure so like you said it’s a type of nerve block it’s an injection and that kind of like you you mentioned it sets us apart from your traditional treatments with medications therapies, etc. So, what we’re actually doing is in patients that have anxiety PTSD disorders their fight or flight system is elevated it’s all amped up and so there are number of different treatments to quell that to calm it down right and this is just another approach okay so it’s a injection done in the neck around the um stellate gangion mhm and the idea is if we can numb that area that stellate ganglion works like the fuse box: the on/off switch for our fight or flight system right and if we can temporarily block that even a temporary block in that system allows months to years of relief from that hyperactive fight ORF flight response it essentially balances your fight or flight with your rest and digest and that resolves a lot of the symptoms of anxiety and PTSD.

Okay so it’s a lot like my computer is running slow let me just reset it safely

And that’s exactly it yeah you know when you’re my kids always yell at me because I have like a hundred apps open on my phone right so so they grab my phone like close all the apps and shut it down and turn it back on and then it starts to run smoothly again and that’s kind of this same idea um if we can do that for a patient it allows this almost immediate effect which is remarkable um as opposed to say waiting for 6 weeks for a medication to kick in this kicks in immediately and it’s not meant to be just a oneandone but it’s meant to allow you to then transition to those more traditional treatments and then they’re more effective because you’re not over responding to these triggers right

so one way you’re saying is that this is the starting point where before this you’ve tried a lot of things nothing’s quite made a huge difference so this can be the starting point then after this and go back to eating right and exercising and therapy

yeah most of the patients that we’ve that we’re seeing we’ve they’ve been through everything you know we we’ve seen them go through counseling and they’ve tried medications and and maybe they’ve had some success but they’ve hit a point where they’re still responding to those triggers and by triggers I mean you know they might have had a bad accident before and they still struggle with panic attacks when they get in a car right and so we want them to be able to move forward and for whatever reason they can’t and and this allows them to quell that overreactive hypervigilant state that they get into when they see the car or go into a social situation that would normally provoke anxiety and so if we can calm that down then once your body isn’t physiologically telling you to Panic it’s much easier for your mind to say okay let’s think this through let’s do some deep breathing exercises and essentially those more traditional treatments become far more effective right wow that’s great and really and unfortunately for our viewers today I’ll probably use a lot of anesthesia analogies since you know finally have somebody on the show who knows my anesthesia but so and this is also telling my age so when I was a student we still had thop Pento and for cored surgeries when they clamp the cored artery we would use styop pentol to take the bis to zero meaning that there’s no electrical activity in the brain it’s there it’s safe but it’s not thinking even a little bit and sometimes I used to think well this reset might be helpful for different conditions and now that you know with the sent Health Center we do a lot of Psychiatry I realize well there’s a lot of treatments like back in the day they used insulin to change your metabolic sense and then maybe get you have depression now there’s ECT electroconvulsive therapy that resets the brain we do TMS trans crano magnetic stimulation that uses a magnet to tell the brain okay you need to recharge this part of the brain maybe with the anxiety portion of your brain we need to tone that down so there’s all these treatments and we’ll of course talk about cam in two at some point today that that’s exactly what they do they reset the brain and let you start over yeah I mean the remarkable thing about the brain is that and maybe people don’t realize but it’s constantly evolving right there’s neural connections that are forming dying forming all the time and and so it doesn’t have to be a static situation and and while counseling and medication and traditional treatments are great unfortunately they’re only helpful for like a third of patients and so you have this group of patients that’s left struggling sometimes hopeless and and so thankfully now all these various other treat treatments are coming into light EMDR and trans cranial magnetic and and stellic gangan block these are treatments that um can really make a difference in a lot of patients lives yeah right and also too for potential patients if someone’s thinking well this sounds a little bit extremer this sounds like a lot well that’s fine you’re probably not that bad off to actually want this sort of treatment so that is the nice thing about all these alternative treatments is that they’re tailor made for people who are ready to stop trying their third or fourth medicine and try something different they’re often not like for example we treat migraines uh at a send but I’ve had patients say well you know I’ve had this migraine I tried this medicine didn’t work and I’ll say well come see me in 6 months because once you’re on your fourth fifth six medicine then absolutely I’m going to come in there and help you but until then like this is not a firstline treatment for what you’re suffering with so you would yeah I totally understand you would think that you know patients are hearing about an injection it’s done in your neck obviously you know there’s some reluctance or hesitation about that um and initially we thought oh my gosh you know are we going to have patients that are even interested but the response has really been overwhelming and not only that but the injection itself is really simple it’s done under ultrasound um you know it’s a it’s a very um easy well tolerated block to do usually just local anesthetic and so these patients afterwards are saying oh my gosh why didn’t I do this sooner this was so easy and effective that you know I don’t know why the the hesitation so what kind of results are you getting obviously there’s always a subset where things just aren’t working regardless of what the statistics show or the data but what’s your typical response to doing this yeah so we just recently looked back at six months of data which we have and and pretty good data and right now we have an 80% response rate which is remarkable again like we talked about tradition therapies a third maybe at best half of patients are responding yeah for Psychiatry I think once you’re on your third anti-depressant there’s an 18% chance that it’s going to do anything for you exactly so um everyone responds differently uh some it’s you know obviously reduce panic attacks and social anxiety and all those things some are just sleeping better um but 80% of our patients are having clinically significant Improvement and the common question question I get is okay but how long does it last right right is this going to last me a week because that does nothing for me um so we looked at that data too and what we’re seeing is about 5% of our patients that do respond so of those 80% that respond only 5% have had recurrence of their symptoms after 6 months okay which is which is really amazing too and again if they can sort of utilize this as a stepping stone as a opening a door you know um a lifestyle change where they’re then um re-engaging with those other treatments they’re far more successful far less likely to need any other treatments um from me and it’s also true that uh oneandone options are very important so we see in the American Medical system that there’s some treatment that develops and then slowly it becomes this constant thing because that’s how companies make their money like uh and again this is Community TV so we can say whatever we want I had a rep come in for I think it was raly they’re like look we’re looking at this PTSD designation for it and uh it’s because again right now PTSD is something that pharmaceutical companies are finally realizing oh there are a lot of patients out here so we can Market these drugs and I’m not saying whether it works or doesn’t work but the point is that um often times uh business models of Health companies are well how can we make this into recuring Revenue so really as a patient any chance that you get to do something and then leave that and do something simpler like you should take it 100% I mean it’s why I joined this company because um I didn’t like the assembly line feel of you know a lot of practices like you kind of described a business model over a healthcare model and and that’s really our focus is good highquality evidence-based Healthcare um we want patients to get better and no that’s not a great business model to never see your patient again but um I mean I think personally if you can give that kind of high quality Healthcare MH that word is going to spread and patients you know family members friends other patients of referral sources are going to come back to you because um because they know you’re you you know you have the right interest in mind you have the right goals in mind right at a end we have whole families who are patients and often whether it’s genetic or it’s environmental if something we do helps one person then it tends to help the rest of their family too right and often too so there’ll be whole systems that are uh affected by PTSD or depression or anxiety and often it is almost like okay which person should we treat and then they can affect the whole system and that way we don’t have to treat the whole 100% I mean it’s it’s systems based within a person and it’s system space within a family and social group right so you have um you know a secondary PTSD in the spouse of the military vet that’s now traumatized and the the wife or the spouse is is living with that that is traumatizing in itself and then you have these this this domino effect within a a given person where you know when you’re anxious you’re hypervigilant you’re not sleeping well then what happens then you feel crummy the next day right your mood’s down your Energy’s down and that progresses to physical ailments within that person so all these sequential effects occur in that person and in all the individuals around them as time goes on so yeah you have to treat it as a whole person and really a whole family right um that’s that’s critical I think in any part of healthcare yeah for sure because I know it’s part of our culture that everyone is this like individual Silo and we have to treat you individually it even breaking it down by specialization like oh wait the nephologist wants your blood pressure higher but the cardiologist once it lower but what we’ve noticed too is that sometimes we need to treat the whole system so yeah maybe your mom isn’t a patient here but we need to Target this treatment so we can help all of you so you the better results and so we’ve seen that we’ve had a lot of families that have come in you know spouses uh parents with their children um um we treat 16 and older but when I say children you know adult-aged children and and that trauma has has you know affected them all or that those U mental health issues have affected them all uh or we even see you know just generational trauma um all the time complex PTSD uh that has essentially been passed down through generations and it’s difficult to treat but like you said it’s important to to to manage that whole picture M and and again a lot this is patients who have tried some things and it still hasn’t worked and it’s not saying that it’s not valid to do what you can whether it’s deep breathing prayer uh counseling but once you do something like this it’s almost like an avalanche where you can start the ball rolling and then all those other things that before because when we first started at Ascend we spoke a lot more about the holistic ways to get better and then we’d have patients saying look uh six anti-depressants didn’t work what herb can I take instead we said no no we we have to hit you with something that’s going to work very well and then we can talk about herbal medicine or a gentler way to treat this but we can’t go from these high powerered Pharmaceuticals not working to you know something like talking to a therapist if all these other methods haven’t worked and you’ve already tried three or four other therapists yeah so and there still isn’t you know I don’t want to make it sound like this is a Magic Bullet this is still something some probably the best example for what we do is a ketamine infusions which you do as well at reset this is something what can start the process and then depend how much work you can do into it is how permanent the changes are that’s 100% right yes um and I mean really that should be true for any treatment often times in our culture um yeah people just want hey what’s the pill what’s the shot what’s the surgery that can fix me um but like we’re saying you really have to look at the whole person right you have to do what you can at this moment so that you can move into those other treatments and all those other things are then more effective but if you look at it as a quick fix regardless of what the treatment is I think you’re going to fail right yeah and I think the important thing is transitioning patients when they need to realize that okay I’m unfortunately not a case where there is one pill that will take care of this and then I can move on this is going to be a longer haul so what can I do for it so yeah I mean mental health is a lifestyle change it really is I mean you have to address um you know productivity and social interactions and coping skills and family and friends and work and balancing all that and otherwise um unfortunately we will see patients just returning and returning returning because they’re not making those changes yeah so it really is uh what we’re both trying to do is Foster some resilience so if the balance is a little bit out of whack you can still get your homeostasis back so to speak absolutely yep cuz I had a patient who came yesterday and uh he had a series of ketamine infusions 15 months ago and after his sixth one I said well why don’t you just talk to our therapist and then just come back to me if you need to and so for more than a year that’s all he’s needed and then he said well I’m feeling a little bit low now that it’s cloudy again it’s like okay no this is the exact plan we had for you 15 months ago that you know this was not meant to be a permanent solution that you had a good support system so yeah and and neurotransmitter imbalance is going to happen right and so that’s when those medications and ketamine and those types of treatments are really appropriate and really helpful right um but yeah it has to be done at the right time in the right setting and with the right understanding of how to proceed forward yeah and that is always a challenge too because you know you’ll see commercials that say oh you’re just missing a little serotonin we’ll get you some store bought serotonin you’ll be fine and it’s just an oversimplification of what’s going on yeah yeah I mean don’t get me started on pharmaceutical commercials but yeah I mean that it it is it is not uh as simple as that and and we see that in patients that have depression their serotonin levels aren’t always really low you know as typically thought um and and maybe it’s something else that’s contribut to that maybe it’s their anxiety maybe it’s high cortisol and adrenaline levels that are constantly pushing through there and that’s causing lack of sleep and that change is what’s causing the depression and not low serotonin so you really have to understand the patient and address that appropriately and and of course that’s you know part of the difficulty sometimes but um but I think you know patients especially when they’ve been through everything right I think they start to under understand that that you know it’s it’s not a simple fix let’s address what we can um and let’s kind of move forward from there right it helps too to not try to go beyond our expertise so you know I think I met you two or three weeks ago and immediately we started shuffling patients back and forth because I like this is great you know I don’t want to do this procedure in my office now you can do it and vice versa with some of our therapists where we can work together and I think that’s the key too is as a patient seeing what a place does well what they’re best at and finding that link of okay I need this provider for this service I mean you can also do too much we’ve had some patients from like you don’t need to come back for a few months you’re set like we don’t want to set the expectation that you have to earn your health and if you do all these things and give this much money and do that then you know you’ll be Beed with perfect health sometimes it is freeing for patients who realize oh I could also do this and I choose not to and I’m no longer in survival mode so it’s ni to have that choice and and I think this right here is really helpful because um I mean in medicine you’d think and maybe other folks think that we all just talk to each other and we’re talking to the primary care and we’re talking to the cardiologist and we’re talking to the psychologist but in reality we’re not I mean we could be a few blocks apart and go our entire careers and never meet each other um but I think that’s really what’s missing in medicine nowadays is that you know that lack of warm handoff that lack of discussion that lack of uh collaboration uh amongst providers and it has it’s great if we can do that more it helps everyone it helps your business it helps mine but mostly it helps the patient right cuz otherwise like what we do is just slap together much like the the sticky sign of behind you that’s now falling apart oh no it lookss it looks great on the surface B while you’re like but are talking to each other or are they just trying to decipher facts notes that are mostly there for building purposes anyway yeah and I know patients uh relate to that when you especially when we talk about medications you know you’ll bring up a medication and be like oh yeah my other doctor six months ago tried that oh I had no idea you know um if we can keep that collaboration going I think patients will be better off yeah and we started to tell patients you need go to your Pharmacy ask for print out of what you’ve tried for the last five years so that way we’re not repeating what somebody else has done and we can start fresh without having to like dig into 10 years of History so absolutely so what else do you all offer there at reset so uh aside from our neurosymptoms.org

do a few different types of IV treatments mostly for immune therapy like a holistic approach and we do myofascial treatment um in the form of trigger point injections okay uh this is an injection essentially to help tight muscles knots which again often if you’re looking for a comprehensive approach patients that have anxiety are usually imuno compromised they’re usually have tight muscles um and and so we’re trying to put together a package that perhaps can help us a few different aspects of their life right cuz a lot of times now we see EDS pots all these acronym syndromes that accompany with the mental health and they’re so tightly wound together it’s not something where you can say okay go to your pots doctor then go to your anxiety doctor then go to your gastroenterologist it’s like okay how do we start unraveling this together yeah yeah absolutely yeah yeah I love the acronyms they’re always like all the commercials now I’ve never even heard of these acronyms right yeah and it’s similar what I was saying earlier that uh sometimes companies are like oh wait there might be a pill that we can use for this because it’s invogue or so we’ll give it a catchy name and give the disease a catchy name and all of a sudden yeah people are because a lot of times with with both what you’re doing with a stellic gangli and blocks and even with a ketamine it is something where okay we have a primary reason to deliver this medication or this treatment but we also know that this could affect five or six other diagnoses that you have so it’s almost like diagnosis by treatment where we see oh okay so this was the cause of this problem 100% And that’s actually what we’re studying right now so and I’m glad you brought that up so yeah we primarily treat anxiety disorders PTSD and certain types of depression but uh what we’ve noticed and what we’re looking at is uh in followup these patients are saying hey by the way my migraines are better right by the way my uh you know I have a history of bulimia and I’ve not had issues in the last month um I have a his history of substance abuse right um inflammatory disorders fibromyalgia so these diseases are often all linked like you’re saying if you’re if you’re an anxious person if you have mental health uh issues you might struggle with some of these other poor unhealthy coping strategies or um struggle with pain disorders or chronic inflammation and they are absolutely all linked it’s why everything is important from diet and exercise to how you’re addressing these and as opposed to addressing them individually with hey here’s a pill for this here’s a pill for that here’s a pill for that um taking a step back and looking at the bigger picture and hopefully in a you know in the upcoming months and years we’re going to start to be able to gather that data and look at at some of these diseases and say Hey you know we can treat this alone but you’re going to be better off if we can take a step back treat the bigger picture absolutely might take a little bit different approach you might not be used to that but you’re going to be better off long term well in your case too for the neurological reset there is plenty of data on like neuromodulation of the immune system just by resetting everything where there’s been cases of pneumonia where they realize nope this is actually your nervous system causing that so uh I think what we’re both saying is if we can get a person’s systems to talk internally instead of the idea of like oh I hate my brain because it makes me anxious or this part of my body isn’t working right if we can create almost like a cohesive unity in your own systems then your body won’t have these Civil Wars where the immune system is trying to protect you from something but causing eczema instead and all these really complex disorders 100% yeah I mean it is complex but like you’re saying at the same time it’s really simple um when your brain is telling your nervous system one thing it often your body responds in an unhealthy way and so yeah you get dermatologic issues and you get inflammatory issues and you get bowel issues and if we can tell the brain if we can reset the brain allow the brain to talk more appropriately with your body communicate better with your body um then it’s helping all these conditions and again it’s helping the bigger picture because you’re sleeping better your mood’s better your you know your social interactions are better you’re positively coping right uh with your disease so yeah it’s about um addressing often the core of the problem uh and then moving forward from that and it’s fascinating too that both of us started in anesthesia saying okay this is a medicine that’ll work in 10 seconds to take care of the symptom and slowly realize like wait there’s there’s ways to get more long-term results but also remembering our background of like no let’s treat this quickly let’s not wait a month to see if this medicine works or what not yeah it it was a weird transition um going from yeah treating you know immediate relief immediate benefit to to hey we need to look at the long-term effects of this and maybe we only need to treat it once and be done right so if anyone’s interested uh where’s your center located what’s going on with you guys uh so reset medical and Wellness Center is in Strongsville our website is the reset center.com a patient if they’re interested um in our neurosymptoms.org

uh we can talk about if this is appropriate for you um we have a couple events coming up in uh October we have a live to lead uh uh fundraising uh seminar uh which is a charity event for businesses that we’re sponsoring and in November we have an open house um at our Center in Strongsville both those events are going to be on our website so the reset center.com best place to go to see what’s up and coming at our place that’s great and for Ascend we’re in feron uh we have therapy traditional Psychiatry too cuz every once in a while yeah you just need a little Z off and you’ll be fine and that’s all there is to it and uh we also do ketamine TMS and our structure as you come see our nurse practitioner psychiatrist and you get sent to me as a nurse and athetist to do the treatments but uh thank you so much for coming on the show today absolutely thank you Nick it’s been a pleasure I really appreciate uh I really appreciate the time yeah it’s been great and informative and thank you all for watching your sign stuck oh yeah it is it’s doing