Latest / The Resting Stitch Face Podcast / Ketamine Therapy, Psychedelics & the Future of Mental Health w/ Katie Walker

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Ketamine Therapy, Psychedelics & the Future of Mental Health w/ Katie Walker · The Resting Stitch Face Podcast

• Erin Sheffield: And welcome back to another episode of the Resting Stitch Face podcast. I'm your host, Dr. Aaron Sheffield, with my co-host. Sarah Harding: Doctor Sarah Harding. Hello, welcome back. All right. Erin Sheffield: Welcome back. We are so excited to be here today. We have a new guest, Katie Walker. Katie, can you introduce yourself to our audience? Katie: For sure. I am in the medical field. So I'm a CRNA and I'm also a psychiatric nurse practitioner. most people I don't feel like know what either of those titles are, maybe, but the CRNA aspect, I did anesthesia in the hospital for about eight years. Prior to going to anesthesia school, I was ICU nurse at a level one trauma center for about ten years. and then I decided it was a good idea to open a ketamine clinic in twenty eighteen and did that for Four years before I went back and got my psychiatric nurse practitioner. and then that's that's all I do now is ketamine. I've been doing that since twenty eighteen. So I've been I've given about twenty five thousand infusions, maybe a little more than that. And really I've gotten to learn a whole new world outside of the Western medicine hospital box. So I was in the hospital from two thousand and three until two thousand and eighteen. Sarah Harding: wow. Katie: And then I've been outside the hospital in the outpatient space since then. Sarah Harding: Wow. And you are in Tennessee, right? You're around the Knoxville area. Okay. That's cool. And then you own Revitalist now, which is the ketamine infusion clinic. And you guys are doing a lot of things. And so the space of ketamine infusion, how did you get interested in doing that? Katie: I am Knoxville, Tennessee. Mm-hmm. I do. Yeah. It's a good question. So sometimes I question it myself. yeah, so so so ketamine, you know, anesthesia, we do ketamine, I know that well. But I was actually reading studies in 2016 about ketamine and seeing the results. And honestly, I was doing a glioblastoma and we it was like an eight-hour case. And you know, I don't know if you know this, but like typically, you know, neurosurgeons we have different Sarah Harding: Ha ha. Don't we all? Yeah. Katie: things that we have to do from anesthesia standpoint. And one of my goals after the eight hour case was to wake up the patient in 20 minutes, make sure they moved all extremities. And even after that long case, you know, the guy still had about six weeks to live. And I was sitting there and I was had read about ketamine and saw all those really cool statistics. And I thought, you know, what would happen if I was actually in the front instead of actually at the end of life. You know, 'cause in anesthesia, we're like the most advanced trained people to help you not to die. And it's like, what happens if you actually push me out to the front with these people that are honestly kind of an end stage brain failure when they're wanting to kill themselves? And what happens if we can actually fix that situation? Because that body is a very viable body. That brain's a very viable brain. And if you can just help me to go up to the front lines instead of the end of the lines, how could we change the quality of life? so Sarah Harding: Interesting. Katie: I started that in 2018 and then gosh, I saw the failures. I still see the failures. I tell people all the time, and I feel like I can say this since I went back and got my psychiatric degree. I firmly believe that the mental health system is a failure. Period. I mean, it you guys as oral surgeons, if you had the results, if you had the statistics that the mental health field has, if I had those statistics, anesthesia or neurosurgery or cardiothoracics, whatever. One, they would take our license because it's that bad, right? I had no idea. It's like thirty to forty percent effective, the medications that are out there. And and it's a life sentence. It's like, you have mild Sarah Harding: Mm-hmm. Yeah. Right. Uh-huh. Erin Sheffield: Are you talking about severe depression or what statistic are you talking about in general? Okay. Katie: All of it. Depression, anxiety, OCD, PTSD, suicidality. you know, everybody's scared to death. If somebody says they want to kill themselves, everybody just they they just run away. And I'm like, hold on, wait a minute, guys, what what are you doing? Why are you not helping these people? And they're just they're so scared of everything. And my personal opinion is we're all gonna die sometime. You know, why not help the person actually live a higher quality of life prior to? Sarah Harding: Mm-hmm. Katie: But since being around ketamine and seeing the psychedelic space, which everyone's going to see this come to the market, we're gonna see efficacy rates that actually start matching some of the normal Western medicine rates, which will be really, really exciting because I I don't see how many of these people are still living. I mean, honestly, they're like I've been on Sarah Harding: Yeah. Mm-hmm. Right. Katie: you know, twenty-six medications since nineteen eighty three. I've tried to hang myself three times. I've you know, and it's just like, How are you still here? You know, so a lot of people have such endurance and I tell them all the time that they're not treatment resistant. I say, You're not treatment resistant. The options we're giving you are no good. And and that's the yeah. Sarah Harding: Yeah. Mm-hmm. Right. Right. Well and then they then they're labeling themselves now I'm a failure because obviously nothing that we have is working on me. I'm the failure. There's something even more wrong with me and it can just continues to spiral. It's just really sad. Katie: Mm-hmm. Yep. Yeah. And and if you start looking at it, I mean, gosh, if you look if you start looking at the data, right? Like the physiology of it, you know, everybody thinks so you have a dopamine deficiency, you have a serotonin deficiency, whatever else. They're seeing that these neurotransmitters actually travel in pairs. So if you start changing your serotonin, you're changing your dopamine, you're changing your nore epi, you're changing your epi, you're doing all you're changing the entire landscape. And it's like again, can we just admit failure and just Sarah Harding: Mm-hmm. Katie: close the book and just start over. And I'm hoping that the psychedelic space will allow us to do that. But two, I'm also scared to death of that because people in the community who feel like they have more pharmacologic training than other people who've had training for maybe 10 years, they're going to challenge the Western medicine world and we're going to see successes and failures. But hopefully it's going to be better than what we have now. Sarah Harding: Yes. Erin Sheffield: So as oral surgeons, we use ketamine all the time in our practices for anesthesia purposes, which you are very familiar with as a CRNA. But what is the yeah, what is the idea behind therapeutic ketamine in this space? What are the what are the similarities to what we're doing from the anesthesia standpoint? What are the differences? And maybe what are the the risks or like the things that patients need to consider when wondering if this is for them? Sarah Harding: And this is what has blown my mind. So Katie: Yeah, no, that's a great question. Ketamine in this fashion, it from a from a mental health standpoint and from a chronic pain standpoint. So ketamine is treating all kinds of conditions. I mean, depression, anxiety, suicidality, OCD, psoriatic arthritis, rheumatoid, you know, just weird pain syndromes. We've had people on eight milligrams of dilatted and we've been able to taper them down completely. different things like that. But the dosing, right, the dosing with ketamine IV. The baseline dose that causes the neuroplasticity is half a milligram per kilogram. so that's that's how we know that we're hitting what we need to hit from a physiologic standpoint. but me personally, like I have my own thought process, my own theories now after just sitting there and just looking at everybody, trying to figure out what the heck is your brain doing. And me personally, I start them off at half a milligram per kilogram, but my goal is to get them to where their brain feels neutral. And that neutrality is where they feel disconnected from depression and anxiety. So you are utilizing ketamine from the disassociative aspect. But if you can do that, it's almost like the brain from a psychological standpoint can start rewriting its narrative. Like I tell people all the time, you know, reframe your narrative, reframe your narrative. And a lot of people can't, but they can if they get to that neutral place. You know, now in anesthesia, I don't know the dose that you guys use. in oral surgery, but we would use two to five milligrams per kilogram IV push, you know, if we were doing a anesthetic with it. And what that does, and I'm I don't know again what you all do, but we would give, you know, versette or propavol or whatever to to counteract those side effects because the side effects are horrible. But what you're doing from that standpoint is you have the level of disassociation, right? And and I was not taught necessarily disassociation in anesthesia school, but I sure saw it when I started doing ketamine. but there's there's basically five levels of disassociation. So it's like none, mild, moderate, severe, extreme. And if it's extreme, it's it makes people look like they're one D. Like I don't know if you've ever seen the movie Inside Out. Have you seen that movie? Where they go through the incinerator and they turn it on. Sarah Harding: Interesting. Yeah. Yeah. Yes. Yeah. Don't remember this part. Yeah. Katie: So they go from four D to three D to two D to one D. So ketamine at extreme disassociation, the world will stop. You look like a square. Actually, I've been told I look like Legos. So but it can become really s right. Yeah, I've heard, you know, people are like, I feel like I'm in the matrix. but but those are levels of extreme. So you you don't want somebody who who's having ketamine. Sarah Harding: Okay. Erin Sheffield: that's fun. They make movies like that. Sarah Harding: Yeah. Yeah. Katie: IV, you do not want them to go to levels of severe extreme disassociation because it can be traumatizing. When you hear people say, I went to the Khole or I had a Khole or I was scared to death. I felt like I died, you know, all these things. Those are severe levels of disassociation. When you give the IV piece, you know, I mean you're giving say you're given 40 milligrams over 40 minutes. You're giving one milligram per minute. Like it's significantly, you know, I tell people it's like one three thousandth of a dose as to what we would actually recommend. And it's interesting too, right? Because ketamine, when you give it through mental health standpoint, it makes people have dry mouth. Which, you know, when in when you're giving it, you know, through I'm sure through dentistry and also through anesthesia, like we used to give Robinol to to counteract the the drooling effects that ketamine causes, does not cause people to drool at all. They do not lose their swallowing reflex. They don't have any of that. so it really it acts as a psychedelic Sarah Harding: Mm-hmm. Katie: And if you look at psilocybin, if you look at LSD, they have similar psychedelic effects as ketamine. But ketamine, from a chemical standpoint, is most closely related to ibogaine that's starting to gain some traction. But honestly, used to, I would tell people they need to fill at least two antidepressants before trying ketamine because that was the traditional treatment resistant. Now, I firmly do not believe that. I personally believe when their function starts decreasing. Sarah Harding: Right. Mm-hmm. Katie: And it's like I just don't feel right. I'm not sleeping. I'm so stressed. I can't turn my mind off. Those are candidates for academy. and and it's so safe, right? It has a huge safety index. Yeah. To where and and when you do it IV, like me personally, I titrate it to effect. If it's too intense, you slow it down. If it's not intense enough, you you add more. so it's allowing them Sarah Harding: Right, that's what I was gonna say. Yeah. You're not getting the serotonergic activation either, right? So we're not necessarily concerned with Katie: Right. ketamine works more so on your your glutaminergic receptors. Yeah. So you don't have to worry. And and she gets along with everything. You know, the only drugs that ketamine doesn't like benzodiazepine, cannabis, and alcohol, but it acts as an antagonistic more so. It just makes it less responsive. It doesn't make it more responsive. but you know, the youngest person we treat is twelve. The oldest we treat is ninety two. I've had people with ruptured aneurysms. I've had people with, you know, Sarah Harding: Yeah. Mm-hmm. Mm. Okay. Erin Sheffield: Well Katie: Actually heart transplants. We've had liver transplants. you know, and again, that's probably my anesthesia background that I feel comfortable with those individuals, but they've all tolerated it really, really well. And it's massive change, like literally overnight. Erin Sheffield: So is it the drug experience itself that is healing? Or is that combining that with like psychotherapy that makes it so powerful? Or like, am I curing my dental phobic patients of their phobia by giving them ketamine sedation? Okay, tell me more. Tell me more about this. Can we start advertising? Well, it's like we're doing both. Katie: You probably are helping. You're probably helping. So yes. Sarah Harding: Yeah. Katie: Exactly. Yes. We will decrease your phobias. you know what? I used to get people to sit with therapists all the time. I mean, that was one of my like go-tos. We have these clinics, we have therapists in with the clinics. And gosh, here's the thing about therapy. How many therapists have you all been around? Sarah Harding: Are you asking how many times I've actually signed myself up to go to it because I really need to do that? lots. Katie: Like not personally. Help. I need help. How many have you worked with on a professional level? Erin Sheffield: Yeah. Katie: Yeah. So so the thing with therapists that I noticed, and here's the thing with ketamine and psychedelic assisted psychotherapy, all therapists have their own opinions of what they should do. There's no standard of care. So some therapists are much better than others. some therapists will try to meet their individual objectives as to what they think the client should do. And and that's completely what you don't do. if anything, you sit there and you help them to feel safe. that's my biggest thing. I'll tell people all the time. I need you to feel peace and calm and safety. so we had studies. We actually have had a couple of studies come out. One was with some neuroscientists from some Ivy League universities, another was with Johns Hopkins in University of Florida. But we compared ketamine and then we did ketamine with therapy. The results were the same. yep. I used to be a firm believer, but Sarah Harding: interesting. Erin Sheffield: Mm. Katie: I have my own, like I've written two books. One's published, one's in the process of being published. but my personal opinion is there's a baseline thought process that you should have before you go into ketamine and it allows the brain to do what it needs to do. but from an anti inflammatory standpoint, I mean they they do say that ketamine has anti inflammatory aspects. It it does help with immune modulation. so I do think that it helps from a physiologic standpoint, but I think if you can get your brain to a psychologic standpoint, your results are so much more powerful. So, you know, they'll tell you after one session that suicidality gets relieved 98% of the time. Me personally, I feel like people change a hundred percent of the time. but it's it's trying to understand what the brain's doing to try to see that efficacy. And consistently they'll say the efficacy is about eighty to eighty five percent. which is about double than your med. So two X to two point five X as what the med efficacies are out there. Sarah Harding: Okay. Yeah. And so your protocol in your clinic is, and I'm assuming it's very patient dependent based on their presenting symptoms, concerns, things like that. can you give us an idea of what you start with? Like do you start with okay, we're gonna do six sessions, and then how often are you doing that? How often are you spacing it? And is it a lifetime thing or is it a you know, short term Erin Sheffield: Wow. Katie: Mm-hmm. Sarah Harding: thing that you recommend? Katie: Everyone, so we do six, we recommend six sessions. and it's interesting, right? So we've got Western medicine and then you've got voodoo, right? So I actually lost my job. I I don't know if I told you this before. I lost my job over this clinic. I had to choose Sarah Harding: Yeah. Yeah. So wait, you tell us that story first, 'cause that I thought that was insanely interesting. Katie: yeah, so in 2018, my goal was to do the clinic and then just go part-time at the hospital. And because I just need a better work life balance, which was not this company, by the way. but but when I I had to meet with my chief medical officer over the anesthesia group, and he was like, we don't believe in mental health. Like you're either gonna do real medicine or you're gonna do voodoo. And he's like, You need to choose. And I was like, Well, I guess I'm gonna choose voodoo. Sarah Harding: Uh-huh. Erin Sheffield: Wow. Wow. Katie: And it was interesting because they they just stopped giving me cases. I was full time. I was a full time salaried employee. They just stopped giving me cases until I fell off. So I never was fired, I was never terminated, I never quit. it just gave me more incentive to to do this, which was interesting. Erin Sheffield: Toxicity of medicine, come on. Like what do you mean you don't believe in mental health? Katie: Right. You know, and now here's the fun thing about it. I tell people, I'm like, this is neuroscience. Like, like there it's it's consistently consistent. It's weird, yes. But what you know what else is weird is when they're like, I have mild depression symptoms and they're like, try the if Xer. That's the first line that you should do. And I'm like, Why why would you get on a medicine for the rest of your life for mild symptoms instead of doing a one time intervention? That's my piece, you know. So Erin Sheffield: Yeah. Sarah Harding: Mm-hmm. Erin Sheffield: Yeah. Sarah Harding: Yeah, with all the side effects that come with that one medication. They you'll then treat with another medication and another one and another one. Yes. Katie: Yes, it's horrible. Erin Sheffield: Or come have your wisdom teeth out by me because evidently I have been running Academy and Clinic all along. Katie: Ex exactly. I will send you my book. My my second my second book's called Exactly. Erin Sheffield: It's all how you market it, right? Like let's like wellness, vampire facials while you're getting splashed and ketamine treatments. Sarah Harding: Yeah. Yeah, yeah. Katie: my second book, Love Safety Trust, I will I will send it to you that you can give your patients before they have surgery and they can read the book Erin Sheffield: Yes. Yes. It's perfect. I mean holistic Sarah Harding: Mm-hmm. Yeah. Yeah. Erin Sheffield: dentistry, man. I'm all in. I'm all in. Just add some ozone and we'll be like set. Sarah Harding: That's right. Katie: Yeah. Sarah Harding: Yeah. So then I know I can't wait to talk about that. So you just decided, okay, that's great. you're not giving me any more cases. So I'm just showing up and sitting here. And then no thanks. Katie: Yeah. Yeah. We are doing Eboo around here too. I'm learning about that. Yeah. Yeah, well well yeah I just said, All right, I'm good, you know, and I just went to the clinic and started, yeah. And I've not been back not been to the hospital since twenty eighteen. Erin Sheffield: Bye. They're just jealous that you were smart enough to do a ketamine clinic when they were. Katie: Well, I'm pretty sure they all thought I was crazy initially. And now they're like, well, maybe she wasn't as crazy as we thought. Who knows? But here's the interesting thing. So six sessions over two to three weeks. When Kenemy first came out, they said six sessions over two weeks. That was the nationwide protocol pretty much. And and it was too much. I mean, some people probably still do that because that was the original protocol, but they were processing so much in such a short amount of time. So we switched to six over three weeks. Erin Sheffield: Yeah. Sarah Harding: Hm. Katie: and it was interesting because the way that they got that was they just compared it to ECT. ECT is is six sessions over two weeks. And you know, the here's the other interesting thing that people just don't talk about is ECT is the gold standard for depression, right? Since 1950, ECT has been the gold standard. The electroconvulsive therapy, so shock therapy, right? So when I did anesthesia, I used to cause people like, yeah, shock therapy, that's so cool. Erin Sheffield: Mm. Sarah Harding: Can you tell our listeners what ECT is? Erin Sheffield: So crazy. Yeah. Katie: you know, but here's the thing with it is like, you know, when we sedate you, we give you a general anesthetic, we put a bite block in your mouth 'cause you're gonna grind your teeth and we shock you to try to initiate a seizure. And that seizure you need to seize for at least ten seconds, but less than sixty seconds to get the most results. But you're screaming and everything else, you know, it's just it's horrible. But Erin Sheffield: it's so crazy that I mean it must have some benefit, but we used to do that all the time in my anesthesia rotation. I did so many of those and it's just like so unpleasant to and it's crazy that shock therapy is the first thing, or you could go take some medicine that makes you feel pretty good in IV, but the shock therapy let's do that instead. My goodness. Katie: It's like caveman. Sarah Harding: Yeah. Yeah, archaic, yeah. Katie: It is. It creates it is archaic. Well, and you know, and so right, so you kill the cells in order to promote new growth, right, is what they think. But you know, the psychiatrist who I worked with when I was like, I was like, hey, I was reading about this ketamine stuff, what do you think? She's like, It's a fad. And I firmly believe it's not. but then there's two articles that came out in the last two years that said, and you all know our egos in medicine, it came out and said that ketamine is not inferior to ECT. Erin Sheffield: Okay. Katie: So what that just not inferior. So so what they just said was ketamine's better than every big pharmaceutical thing out there, right? Because ECT is the gold standard. So if ECT is the gold standard, well then big pharma came in what in the 1960s and 70s per se with SSRIs and tricyclets and Ao Is. so if they came and just said ketamine's just as good as ECT, hey big pharma, just throw away your Erin Sheffield: The wording non-inferior. Sarah Harding: Right. Erin Sheffield: Are they giving ketamine I feel like we always did propofol, but are they giving ketamine with ECT too? 'Cause maybe that's confounding the results, you know? Like, this ECT's really working and maybe it was the ketamine all along. Katie: Honestly, I don't know. I Right. I know f Sarah Harding: Yeah. Katie: Exactly. Sarah Harding: Yeah. Katie: We used to not do that. But but my piece, right, is if you look, if you go down rabbit holes and you look at general anesthetics, people who've had repetitive general anesthetics have it huge increases of dementia. So if you're getting six general anesthetics with ECT over two weeks, and a lot of times I'm like, How many ECT treatments have you had? I had 73. I'm like, well, when did they think they were actually failing? Like and they lose their memory. They'll tell you that like less than one percent of people lose memory. That is such a lie. Because every person that I've ever had that's had E C T, I'm like, Did you lose your memory? A hundred percent of do. 'Cause it's gross. you can't control it where it's going. Erin Sheffield: Yeah, yeah. Sarah Harding: Wow. Erin Sheffield: yeah. Sarah Harding: Yeah. Mm-hmm. Erin Sheffield: Yeah, I saw that too with the patients. And it's crazy. Yeah. As you were talking, I was thinking the exact same thing. Like, so you can have anesthesia, which has some lingering negative brain effects, or you could have ketamine, which can do some of the same things, but have a pro. So that's pretty crazy. And it's it's the conversation just about how we dig our heels in in medicine sometimes and we build our egos around things and sometimes we just don't know and how Katie: Is pro. Mm-hmm. Sarah Harding: Yeah. Erin Sheffield: Sometimes we don't want to give up our old ideals, even though the research shows. And one example in our field is like antibiotics for pre-meds for joints. Like they're not really saying to do that anymore. They've been saying for the past like ten years or more. And there's still so many people doing it, like, well, I don't want to get sued, or better to do it than to not. And it just doesn't make sense. Sarah Harding: Yeah. Katie: Right. It's harmless. Yeah. Yeah. There was a study that came out about antibiotics the other day. I was reading it and it was talking about like one round of antibiotics increases a person's symptoms of depression for like almost up to forty percent in the first year. Yeah, it's interesting, isn't it? Sarah Harding: Yeah. Right. Yeah. Erin Sheffield: Just doesn't make sense. Wow. Really? Wow. Well it makes sense 'cause they talk about Sarah Harding: yeah. I totally believe it. Yeah. Like the gut brain access is so strong. Yeah. Erin Sheffield: how your gut biome what affects serotonin or something. We're like finding out that that has our it's like our second brain in our gut. And so Katie: Guess where most of your serotonin is? you maybe you all know this. It's in your cholesterol. So it's like when we're giving these people all these anti lipids and we're decreasing cholesterol, it's already making their depression worse. I'm like, do do any of us actually know what we're doing? Mm-hmm. Erin Sheffield: Yeah. my gosh. There's so much we don't know. It's all intertwined, which is our whole bodies Sarah Harding: I mean, so much. Erin Sheffield: are systemic and we forget that. We start thinking it's your emotional side of your brain is separate from everything else and it's not. That's crazy. That's absolutely crazy. Sarah Harding: Yes. As it turns out, they everything's connected. Right. Katie: Mm-hmm. Sarah Harding: Right. And so Katie, Katie: Yeah. Yeah. Sarah Harding: does the the half life of ketamine, so how if you're doing six sessions over about three weeks, the half life is short, right? Okay. And so you're allowing for time for processing of the experience that you had. Is that is that kind of the thought process of it? Katie: Mm-hmm. Yeah. So from the processing standpoint, like ketamine will kick in in like two to ten minutes. Like it's a slow onset. and then but then you start feeling different and you're like in this zone of thought, right? there's so much still that doesn't make sense to me, but when I discover it, it's like a little golden nugget I found. And so I tell people, you know, you've got your conscious thoughts and you got your subconscious thoughts, which maybe is completely voodoo when we say conscious versus subconscious. And I I'll tell people, you know. The only profession that looks at consciousness are those who sedate, right? So it's like you're you're awake or you're twilight or you're general anesthetic. Like what those are the three levels of conscious. And it's interesting because the state, different states have like, you're changing their consciousness. This needs to happen in a surgery center. And I'm like, no, no, no. You're in a different level of consciousness when you're studying for an exam versus if you're playing in the field with your children, right? You're in a different level of mindset. Sarah Harding: Yes. Katie: And that's what it does is it changes your mindset. So ketamine really works on your subconscious mindset. So there's a statistic that came out that said 5% and all decisions we make in life are based on your conscious thoughts. 95% is your subconscious. So I all tell people the conscious brain is your actions and the subconscious is your reactions. So conscious brain is what am I gonna wear today? When am I gonna go to the grocery store? Sarah Harding: Hm. Katie: You know, that's like the conscious thoughts, which is five percent, which if you think about talk therapy, that's the conscious brain. Like what's bothering you? You know, and we tell people optionally what we think's bothering us. The subconscious is stupid, simple, strong. And they think like right now, they think that we're processing at least twenty-two emotions. They think that in every conversation we're processing twenty-two emotions. And I'll tell people on a good day, I might guess five that I'm processing right now. But think about all the sensory aspects that are going off right now. Like we're intaking light and sound and our temperature's changing. heart rates changing. If there was an ant crawling on our ankle, we would feel that. So there's probably millions of subconscious processes that are going on. And and that's really who's ruling the roost. So when we try to like overanalyze and do all these other aspects, we're doing it through our little baby, conscious brain, and we can't understand the power that. Sarah Harding: Mm-hmm. Katie: maybe a color has or a shape or a rug. You know, just things that we would have never in a million years have guessed actually had impact. And I'll give you an example. we had a lady whose child passed away. We get a lot of acute loss here. and child passed away and it been ten years before she came to us. She'd been in trauma therapy for ten years. Because the issue was not that he had died, the issue was that she was stuck. And couldn't remember anything except the day that he died. No memories. And this was an 18-year-old child that died, right? So she had no memories prior to during her ketamine session. She, and this was like 20 minutes into it, right? And here's 10 years of therapy, 20 minutes into ketamine. And she says, The rug in my living room keeps coming up. And she kept on trying to think about something else. She was sent with a therapist, therapist trying to lead her somewhere else. And she's like, The rug keeps coming up. And we're like, all right, tell us about the rug. Sarah Harding: Mm. Erin Sheffield: Well Katie: So she told us about the rug. What had happened is when the police came to her door to tell her that her son had passed away, she was staring at the rug. And that's where her sympathetic nervous system shut down. Once she processed the rug, all of her son's memories came back. Like she started crying immediately. And she's like, and and all of them came back. So it just got stuck. And you know, and if you're a mom who are like, hey, I lost my 18 year old child to a traumatic event. And Erin Sheffield: Yeah. Well. Sarah Harding: Yeah. Katie: I really need to talk about the rug in my living room. You know what we would do? We'd probably just give you meds or go ahead and admit you. But but that's what the subconscious was stuck on, you know? And and so it's those things to where a lot of people are scared to death of ketamine. And I'm like, it is not going to bring up what you think it's going to. I my personal opinion is it brings up what grounded you during an event that took your control. Sarah Harding: Mm. Yeah. Yeah. it's so interesting. Erin Sheffield: Ha ha ha. Katie: So my my personal opinion, you know, is the brain functions on the universal laws of physics. Like every action has equal and opposite reactions. So when the brain hits conflict, it goes to polarities. So if it's a trauma or whatever you want to say, traumas take your control. What actually grounded you? So from what I can tell with ketamine, ketamine will bring up the things that grounded you during that time that gave you control. Sarah Harding: Mm-hmm. Katie: But the brain makes all these different grids of connections. So every time you might have a a hairband that you think about, and that hairband might remind you of, I don't know, when somebody pulled your hair out or something, you know. But it's every time you see a hairband, you're like, I don't know why. I get all anxious. But the brain is not eclectic. It just moves so fast it looks like it is, but it makes connections on a subconscious level. So I'm like, I tell people like, focus on the color. Sarah Harding: Mm-hmm. Erin Sheffield: Mm. Katie: Focus on the sounds, like you know, and I'm like, reset that nervous system and all those sensors that are going off, which is completely what we don't talk about in mental health at all. Yeah, it's crappy. Sarah Harding: Yeah. Erin Sheffield: Can you talk about Sarah Harding: Yeah. Erin Sheffield: some of the fears behind it? Like you said, some people are terrified by it. Some of the things I assume I was taught, Sarah was probably taught also like contraindications. Don't use ketamine on people who have like antipsychotic medications, et cetera, like psychiatric illnesses. And that sounds so backwards from to what you're saying. Like that's a benefit to them. Sarah Harding: Mm-hmm. Like, this person has PTSD. We stay away from Erin Sheffield: Yeah, because it might trigger a traumatic experience Sarah Harding: ketamine. You're like right. Katie: Mm-hmm. Erin Sheffield: for them. And I've only I've only had one really bad reaction on a patient. And this was a dental student when I was a resident and I was taking out her wisdom teeth. And at the end I hit her with a little ketamine and she woke up screaming bloody murder. Just screaming, screaming, screaming. It was terrible. It was really hard to calm her down. And at the end she was like, I thought I was in the planet of the apes and I thought you guys were coming for me. You guys were the apes and you were like chasing me down and trying to get me. And so like clearly there can be these negative experiences and that's why we have been warned. Sarah Harding: Like how when was she grounded in Planet of the Apes? Right. Right. Katie: She probably just watched it. Yeah. Erin Sheffield: So yeah, but what are what's your explanation for that? And should we be avoiding this in our patients with those diagnoses, or do you think it actually is okay for us to give ketamine to them in our clinic? Katie: Yeah. I I think it's okay, but I think you have be careful with the dosing aspects. my biggest thing is safety. Like I'll tell people all the time, do you feel safe? You know, because if they don't feel safe, that's when they trigger and God knows where they go. but I think ketamine should be a first line treatment for PTSD. A hundred percent all day long. Most people with PTSD, when they get ketamine, if dosed correctly, they feel peace. They feel like, my gosh, this is the first time I've had hope. Erin Sheffield: Mm-hmm. Mm-hmm. Katie: And sometimes they'll cry when it's over. Like it's crazy. but the ones that I'm very careful with are people who've who who tell me that they're like bipolar one or they've had mania in the past, because again, my personal opinion, I think the brain does one of two things so fast it just looks like a very complex algorithm and ketamine slows it down enough to where you can try to see what that puzzle's doing. But people who have mania, disassociative identity disorders, they're living in an abstract space mostly. Erin Sheffield: Mm. Katie: So like that whole concentric world, you have to like rebuild it for so when you give those individuals, you can still give them ketamine, but me personally, I give them enough to actually pull them from the abstract world. 'Cause you don't want to give them enough to make them too abstract. You're trying to bring them back to baseline you're trying to make them neutral again. and it's interesting, right? 'Cause Sarah Harding: Okay. Yeah. Yeah. Katie: the people that you'll struggle with the most with ketamine are people who don't know how to sit in the present. There's a lot of people when they struggle with mental health, they are scared to death to sit in the present. They're always thinking about what they need to do next, you know, and they don't know how to feel peace and relaxation. So if you have those individuals Wait, is she in my head? Be in the moment. Be in the moment. Yeah. Sarah Harding: Are you talking about me? Erin Sheffield: I know, I was like, wait a minute. As we're talking, I'm like, what do I need to do next? I'm like, no, come back Sarah Harding: Hmm. I know her. Erin Sheffield: Just focus on your breathing for a minute. Katie: But Sarah Harding: Ha ha ha. Katie: well actually here, if you ever get people who freak out, all you do is you say, Are you safe? And they'll go, No. And you'll say, I need you to take five, three second breaths. And then that will pull them back in the present. Because if you have people who have panic attacks, people have panic attacks, they actually can't do low grade math problems and have a panic attack at the same time. so if you're like if somebody's had a panic attack, you're like, What's one plus one? What's one plus two? They cannot answer you and have the panic attack at the same time. So that's your concrete and your abstract. They just stare at you. Erin Sheffield: No So usually they just don't answer me, right? Or will they answer me? I should ask them to do math, but I think they'll just be like Yeah. Katie: Right. But no, I tell people now, because we run a pretty smooth clinic, but I tell everybody I give them my TED talk before they start. Because let me tell you, this is huge. And I think this is really big. I think one of my skill sets in life is I can assess people pretty well. And you know, I think that was my anesthesia piece, right? Because we used to paralyze people and would have to assess them before they would actually move. Well, now I actually have live talking bodies and it's amazing. Erin Sheffield: Mm. Sarah Harding: Mm-hmm. Katie: You know, so can really do a great assessment when they talk to me. but one thing I've noticed, and I think this is in mental health, I think this is just in everybody's health, is and it's my actually it's my second book. It's called Love, Safety, Trust. And there's something big about love, safety, and trust. And from what I can tell with people, I do not think that mental health is random. mental health issues, I do not think they're random. It seems to happen when people have an identity change, and it seems to happen within a six-month interval. Sarah Harding: Yeah. Katie: So it's usually, you know, between the ages of five and seven, eleven to fourteen, when they graduate elementary school, middle school, high school, when they change jobs, when they move homes, when you have a child, when you get a dog, it's something that changes your day-to-day pattern. And that old identity's gone, right? It's dead. And you have to create a new one. Well, for a while I was like, what the heck is in a new identity? But one thing I've noticed here at the clinic is the three things that come up the most love, safety, trust. And and but it's an internal and an external aspect. So it's like, how do I know that I'm loved? How do I show others that I love them? How do I know I can trust myself? How do I know I can trust others? How do I know I'm safe? And how do I know that others are safe around me? If you can answer those six questions of those three topics in a new identity, it's almost like it recreates your North Star. Erin Sheffield: Hm. Katie: And then you can start building momentum off of that. Because most of the time I'll tell people, because I'm like, I hate emotions. I mean, like I love them when they're used appropriately, but when they're like controlling everything, they just need to go away because they're useless. but you know, a lot of times I'll say, you know, how do you love yourself? I don't. How can you trust yourself? I can't. How do you you're safe? I'm not. I'm like, those are all three emotional answers. I need you to visualize what you think that would look like. You know, so if people can start visualizing what they would want it to look like in this time of life. Sarah Harding: Mm-hmm. Katie: It's almost like the brain can reframe its narrative to where it is. And I think that's the beautiful piece with that brain plasticity. Sarah Harding: Yeah. It's like manifesting, right? I mean, it's the same idea. Yeah. Being able to visualize something and then like because you're able to put yourself in that place, you're able to manifest that I am in that place. And so if I am in that place, this is what this looks like. Right? Yeah. Katie: Yeah, but but the thing Yeah. It it's giving you some target. Right. I'll tell people we just need to make a new map. Like burn your old map. We're gonna make some new legends today and we're gonna build a new map. But if they can't answer what love, safety, and trust look like, they're chasing a white rabbit. And and the field posts are moving. So I'm like, Do you feel like you're in a psychologically abusive relationship with yourself? And people are like, Yes, you know, and I'm like, Okay, let's let's try to get some baseline definitions that this little brain can understand. and then it will start integrating and people start to feel like themselves again. Sarah Harding: Mm-hmm. Erin Sheffield: So is this something that's ever covered by insurance, or I'm assuming this is cash pay only? Sarah Harding: Yeah. Katie: The better version. Cash pay unless you are in, and actually this says a lot, doesn't it? Blue Cross Blue Shield of Vermont and Blue Cross Blue Shield of Massachusetts covers it. So thank you, Harvard and Yale. Yes. Yep. But I think Kaiser Permanente used to. I don't think I don't know if they do anymore. the VA covers it. The VA's been covering it for veterans since twenty seventeen, but the crappy part about that is they make them fail for medications and they also offer them ECT. Erin Sheffield: Okay. Progressive Northeasterners. Okay. Okay. yeah. Katie: And then they'll offer them ketamine as a sixth line. Yes. Erin Sheffield: See, Sarah Harding: Yeah. Erin Sheffield: and that seems like Sarah Harding: And think about how much financial drain that that is Erin Sheffield: How much does it cost to do six general anesthesia? You know, like my gosh, like Katie: Yes. yeah. I mean E C T when I left one in twenty eighteen E C T was like thirty five thousand dollars for two weeks. Right? And that's what the insurance is paying. Erin Sheffield: my gosh. Yeah, sometimes it is not sensical at all. Yeah. Sarah Harding: Yeah. Katie: No. Like none of it makes sense. So yeah, I went up against the Blue Cross Blue Shield Board of Tennessee and I just knew I was gonna win. I lost tremendously. Like, I was such a loser. Yeah. But they're but they I feel like they admired my stupidity, you know, as I was arguing with the psychiatrists and their lawyers. but there is there is a well and there's actually a there's a way, there's a process and they told me which Sarah Harding: No. Erin Sheffield: no, come on Blue Cross. Let's do something good for once. Sarah Harding: But somebody has to plant the seed. Katie: chapter book in their little thing, you know, that I have to do in order to get that done. But it needs to happen, right? I mean, I charge like 360 for a session. And you don't really hear that. that's a pretty low number. the average cost is 500 to 800 per session. yeah, because I mean it's an IV and it's malpractice. You're still having to get anesthesia malpractice, you know, things like that stuff too. So when when the other psychedelics come in, you know, and here's the fun part. Erin Sheffield: yeah. yeah, definitely. Katie: This tells you, I don't know, as we get older, do you just people get stupider or do do we just become aware of their stupidity? You know? I mean, that's where I'm at. but you know, Medicare has a psychedelic CPT code that was created in twenty twenty four. But here's the fun part. There's no accepted definition of what a psychedelic is to this day. Erin Sheffield: Really? Katie: We've had a code for two and a half years, but apparently they're gonna start covering it. They were they were planning on MDMA in twenty twenty four that to get approved and it got denied. And they're repeating the phase three trials and it it only got denied because the people who I greatly love who helped to lead MDMA initially are just a big bunch of hippies who thought the FDA was stupid and the FDA ate them, kind of. but they were very supportive and said, you know, go back, redo, because they didn't track, you know, the rate of diversion. Erin Sheffield: Well. Sarah Harding: Yeah. Erin Sheffield: Mm, yeah. Sarah Harding: Mm-hmm. Katie: And they didn't track addiction at all. They didn't have the data at all. They're just like, Nobody gets addicted. Well, where's the data? We didn't track it. Sarah Harding: Right. Yeah, right. Erin Sheffield: So can you talk more about the other psychedelics? I assume they have their own. Sarah Harding: That's what I was gonna say, because Ibogain doesn't have that addictive that addictive capability, right? Katie: Mm-hmm. Erin Sheffield: Right. Katie: Mm-hmm. Well. Erin Sheffield: I assume they have their own profiles, their own benefits, pros and cons. Is that true? Or are they all kind of doing the same thing? Or are there some diagnoses like mushrooms are good for this and MDMA is good for that? What if someone's curious in seeking out these treatment options, how do you narrow down to the one that's best for you? Does does it even matter, or you just kind of dabble and see how it goes? What's the thought process? Katie: I feel like most of the world dabbles and sees how it goes. but you know, but from a I mean from a legality standpoint, I mean ketamine's legal everywhere, right? Across the world, across the country. it's legal. but you know, it's IV. most now there is home ketamine. You gotta be careful with that 'cause some of those physicians are given bigger than general anesthetic doses for at home use. yeah, like really big doses, which shouldn't happen. but whatever. Each turn. but Erin Sheffield: Ooh, mm. Katie: Ibogaine, so Ibogaine is Trump did sign an executive order about a month ago that is going to help to reschedule psychedelics from Schedule One to Schedule Three, which is what ketamine is. but you know, they're all still illegal, I guess, to a point. but Ibogaine through a lot of different states has been getting a lot of approval for a lot of research dollars. So what you have to be careful about with ibogaine, and because right now it's mostly in most people go to Mexico, and it's a lot of veterans that are actually participating with ibogaine, it's changing their life. but what scares me the most with ibogaine is ibogaine is cardio toxic right now. so it leads to torsods or acystole. It can, and it's like one in 400 people it can happen to. but there is an amazing researcher at Columbia University who made ibogaine cardio safe. And I met him in twenty twenty four and he said it's gonna go into human research in twenty twenty six. So I'm guessing that's why they're doing this big push right now because Texas just put a hundred million dollars into Ibegaine research. so I'm hoping that Dolly More Thames is this guy's name who who's just an amazing he's been working on it since twenty thirteen. so that's that's what I'm hoping with IBogaine. But IBogaine after one session, right, is treating addiction almost ninety percent of the time. Sarah Harding: Okay, yeah, yeah. Katie: after one session, but Ibogaine can last, you know, twelve to thirty-six hours. It's a it's a pretty intense session. so but ibogaine's good for I think addiction is probably the biggest thing they're gonna look at, but it's helping with all of them. You know, we did have a study that came out that showed that PTSD symptoms and depression, anxiety, insomnia, they all run together. And so ibogaine is is the hardest I'm gonna say psychedelic that's out there. Sarah Harding: Yeah. Yeah. Katie: LSD, the Netherlands has a lot of good studies with LSD to where it's actually helping to address anxiety. And somehow they've got it down to where it's a 20-minute session with LSD. psilocybin probably has the most data. Johns Hopkins has the most data with psilocybin. Psilocybin is probably the most gentle psychedelic there is, and there is microdosing that a lot of people participate in that helps with you know, depression. And the thing with that, there are there is a lot of Erin Sheffield: Yeah. Sarah Harding: Yeah. Katie: recommendations for the microdosing but what you have to be careful with with psilocybin is psilocybin actually stimulates beta cell production. So if you're on psilocybin, they'll just tell you like do not microdose every day because your beta cells right mostly in your heart and if you have valve insufficiencies it can actually make heart disease worse. So I always tell people if you want to do microdosing, which is completely illegal in Tennessee, follow up with cardiologists, get them to do an echocardiogram on you and just do a baseline. but psilocybin, you know, the big doses of psilocybin is helping people tremendously. I would say it helps the most with depression is probably one of the biggest things that psilocybin's helping with. MDMA, which is ecstasy, is helping a lot with PTSD. But honestly, I think all the psychedelics are helping. They're they're cross-correlating. it just depends. Are they working on the dopamergic, serotinergic, glutaminergic, like where are the little guys, you know, where are they working? And and ketamine will be under that psychedelic umbrella. as well. but the communities they want it all to be natural. but they don't understand that, you know, digoxin's natural, opium's natural, cocaine's natural. Just because it's natural does not make it safe. And the community feels like that is it's safer, you know, and it's not. but but yeah, but it I think it'll it's gonna be an exciting few years. I think we'll give people a lot of hope once we get there. Sarah Harding: Okay. Erin Sheffield: Yeah. Sarah Harding: Right. Erin Sheffield: Mm-hmm, mm-hmm. Sarah Harding: Yeah. Erin Sheffield: So when things become legal, are you just like biting at the bit to add those into your clinic? Katie: yeah. Absolutely. Yeah. Tennessee Tennessee, believe it or not, just approved Ibegaine for research that started July first. so yeah, so we we've got the we've got the building to actually do it, but it's gonna change. I mean, like there's a lot of bad people in the mental health space, like in the addiction communities, you know, and the rehabs and you just hear horrible trauma stories. I feel like that's what's gonna happen in the psychedelic space as well. Sarah Harding: Mm. I heard that. That's awesome. Yeah. Katie: There's gonna be a lot of bad that comes because there's gonna be so much money in it. But there's so many healers that are out there. And, you know, and that's something I went through and that could be another podcast to where I took this company public and got greatly taken advantage of from a financial standpoint, to where there was a lot of psychedelic companies and on the Canadian exchange, because you can't be a psychedelic company in the US because it wasn't federally legal, but you could it you could in Canada, all those companies Sarah Harding: Yeah. Erin Sheffield: Right. Katie: went bankrupt except mine. Mine's just a shell. I resigned from it in January. I was with it for five years. And I gave everything. I gave my marriage. I gave my four one K. I gave everything to this. And I it was I was just left with the bag after I got pumped and dumped. And there was over a billion dollars invested in the psychedelic space in Canada and they lost it. Like there's a lot of people who made a lot of money off of that. But it was a it was a scam. Sarah Harding: Yeah. Erin Sheffield: Hmm. Well Wow. Katie: So I Sarah Harding: Wow. Katie: feel like that's what's gonna happen for a a while until people can learn from it. Sarah Harding: Yeah. Well, I also think too, you got into the ketamine clinic space pretty early on. I feel like there was this big boom of ketamine clinics popping up everywhere. And it's like, ooh, you know, when something happens like that, it's like the cannabis stores and things, and then like that's only gonna be so long before there's winners and losers, and there's very few winners and a lot of losers. but then you also wonder the people that are being treated at those places. you know, how are they doing and how is it is it legit and is it are they dosing them appropriately and and so I think that's where a lot of the skepticism, at least from what I understand, like when I'm talking to people, that's a lot of where the skepticism comes in, is because there was a big boom and then it was like, ooh. Katie: Yeah. Yeah. Yeah. I mean it's it's been interesting. You've had to evolve. I mean, I've had to evolve a lot, you know, but fortunately, I don't know. I think we've had like six or seven papers published, you know, in pretty big journals and just learning from it and trying to be a leader in it. But if you were in it just for the, you know, thinking you're gonna make money, I mean like I have lost millions of dollars on this company. I have not made I mean, I could be back at the hospital making like 10X as to what I make now, paying off a lot less debt. Sarah Harding: Mm-hmm. Yeah. Yeah. Yeah. Katie: But but I I think that the value of it will we'll get there. But gosh, there there's been so many people. I have no doubt that people have killed themselves, like clients and people running businesses. Like it's just been nasty because cause you see it, right? You see the results but then people are like, my gosh, look at the margins. And then you get, my gosh, I have dealt with I didn't even know they made people like this in life, you know, but are as somebody told me they said, You well, you what a con artist is, you it's called a Erin Sheffield: Mm. Sarah Harding: Yeah, yeah. Katie: haunt artists. They're convincing. And yeah, and that's that's something in medicine that when you come out and you start doing these things, you got to be so careful because I'm like, why wouldn't you want to help adolescents? Why wouldn't you want to help first responders and veterans? And they don't care. They want money. And I have been a lot of people's pony that has danced and brought in a lot of money because people trust me because I'm doing it for the right reason. But Erin Sheffield: Right. Sarah Harding: Right. Mm-hmm. Mm. Katie: It's the people in the back end that like I'm I'm getting a lot tougher now than what I once was. But gosh, it's it's a nasty world out there. Sarah Harding: Yeah. Mm-hmm. Yeah. Yeah. And so what other things are you guys doing because do you have two clinics, Knoxville and Johnson City? Okay. And then what all are you guys doing? Katie: Mm-hmm. More in Johnson City. Yep. Yep. We have, so we have vitamin infusions, which I used to not believe in at all. Now I'm a firm believer. we do like high dose vitamin C. Amazing. we do glutathione, the Myers cocktail, which is just a multivitamin. the reason those work though is because they're a hundred percent absorbed on a cellular level. So way different than if you take them by mouth. The max you can absorb when you take it by mouth is forty percent. so you know, we do vitamins, I've started doing med management. I used to be completely against that until I saw actually how bad the management of the medications were. so now we actually do med management to try to taper people off to maybe put them on more natural things. so we have our own supplement lines with mushrooms, like the legal mushrooms. So cordyceps, raishi, lion's mane, those different things. And then we also have Ibu. Which is EBOO, which is one of our new things. And it's extracorporeal blood oxygenation and ozonation. And actually, you do bilateral IVs and it circulates three liters of blood over the course of an hour. but you ozone people, so you get MO3 right for a while. And it does a lot of different things. It it was really interesting because I got trained by a naturopath, and as he was talking to me, I was like, This sounds like ECMO. Sarah Harding: Tell us about this. Katie: And he's like, Well, we don't have any studies comparing EGMO versus EBU. And I'm like, But you should, because EGMO is very validated in the medical community. And but what it seems is that EBU is it's the FDA has said that you can say that it it helps with inflammation. They have said that, which I think is huge for the FDA to say that. but it was a nephrologist who actually created it in the nineteen nineties. And Sarah Harding: Mm-hmm. Yeah. Katie: It helps from what I can tell. to clean the blood. it's a filter. It looks like a dialysis filter kind of thing. And but it will take out plaque. and then it helps with it breaks down biofilms, which I didn't really know much about biofilms. you know, so you do? It's a big thing. Yeah. So Sarah Harding: Mm-hmm. Okay. we know all about biofilms. That's a yeah. Well that's like dentistry in general, right? Yeah. Katie: Yeah, so so so EBU, the ozone takes down biofilms, you know. So it but it also helps with like your reactive oxidation species, you know, where so you get that and then it starts leading to cancers and all the other long term effects. so we actually do EBU and then we give people vitamin C that actually helps to oxidize some free radicals. so it will help to decrease a lot of those different aspects but the people I've had, you know, I've I've had I've seen watts of plaque, like cholesterol, like stuck. I don't know if you ever used to draw blood on people and you see the cholesterol float to the top of the vials. you'll see that actually stuck, the filter will catch that. but it's interesting though too, because you'll see people they're like, I did Eboo and I pulled out a clot and the clot was like eighteen inches. And I was like, before I went to training, I was like, I just don't think that that is physiologically possible. Like they would be dead if you had an eighteen inch clot come out. And so it does take off fluid and the fluid's supposed to be clear, but it takes off cellular inflammation. So a lady we just she has horrible lung issues, but we took off 450cc off of her in an hour. And this was like two hours ago. That's why I have a different shirt on. but if you see people who are doing eBoo, and if they have long clots. Sarah Harding: Interesting. Katie: Or if they have that clear fluid that's yellow and they're like, this is all the toxins in your blood. If you see clots or if you see yellow with your inflammation, they're breaking down your blood cells. They're hemolizing your blood cells. That's what the yellow is. So they're being way too aggressive with the ozone. so it but it but it does. I mean, we've got a 16-year-old right now who we're treating who has mono, chronic mono. She's missed school. She did it one time and she felt completely different. Sarah Harding: Right. Erin Sheffield: Yeah. Katie: this is Sarah Harding: Interesting. Katie: an hour Sarah Harding: Yeah. Katie: long session. Yeah. So I think there's a lot of good to it, but I just have to figure out how to translate it from the naturopathic world into the Western medicine world and try to figure out actually what's really going on. Yeah. But it's fun. It's like a little I don't know, it's a little it's little puzzle. Puzzle of life. Mm-hmm. Sarah Harding: Mm-hmm. Yeah. Yeah. Yeah. Yes. Yeah. Wow. Erin Sheffield: Sure. Sarah Harding: It's cool. So my the way that I met Katie was one of our friends, was introduced to you during a postpartum spell where she was just having a horrible time. And she knew that she was gonna have a horrible time because she had a horrible time the first time and the second time. She was prepared. She'd like set up all of her support system. She was ready to go. And again, postpartum anxiety depression is incredibly strong and resilient to all the things we tried to change about it. And so she, I think, had reached the end of her rope, had gone and tried the medication she tried last time. She tried a different medication that has just been approved. That also did not work. And she was just hopeless, right? and she found you and was treated by you at Revitalist. And the first session, I think, had a good experience, had a really interesting like visual stimulus that she was visualizing, and but didn't necessarily feel relief from a soul perspective. But after the second session, that really clicked for her, and then after that. Talking with her was earth-shattering to me because it was night and day. I mean, just insane. And so then I went and visited her, and I wanted to come meet you. And so she had a session scheduled. So I got to sit in. Thank you for letting me do this. I got to sit in on the session with her and I asked her questions during the whole thing and I kind of let her guide me because I had no idea what to expect, right? I I give ketamine all the time. And I just like still didn't know what at all to expect. I was like, are you aware? Are you able to talk? Are you, you know, all of the questions? And she, it was just the most amazing experience. And I was on the other side of the room and I'm in tears. You know what I mean? Just being in the presence because I could feel it, because I'm such an impact. Katie: Mm-hmm. Uh-huh. Erin Sheffield: Okay. Okay. Sarah Harding: But I could feel it coming from her too. You know what I mean? Like and I and I and I just could like all of the things she was saying, I just could feel them. And it was just this, it was something so incredible that is so hard to describe and really sounds woo-woo. You know, but but her mindset shift and the change in her ability to communicate and to experience life shifted so dramatically that I was like, there's something here that is. Katie: Phew. Sarah Harding: powerful and needs to be talked about more because everybody that I talked to about it was like, ooh, that's scary. I don't know. I don't think that that's appropriate. I think that that's going too far. Like, shouldn't she just get on medication? I'm like, you're gonna make somebody sit on medication that doesn't work for a lifetime, as opposed to having this and having this life changing thing. And they're like, well, isn't she just gonna relapse? I mean it's to hormones, right? So they're just gonna come back and attack, you know? Yeah, exactly. Capsulize that thing. Katie: He's the eater placenta. Erin Sheffield: Ha ha ha. Katie: Right. Sarah Harding: And so you're encapsulate that thing, whatever they call it. But yeah, so how you must see this all of the time. And what have been your successes? And also have you seen people that aren't that it doesn't help? Because I've heard of patients like or people like that too. I don't know them, but I've heard from friends of patients that have had ketamine therapy and it didn't really seem to matter. Katie: Yeah. Yeah. No, I mean, you know, I'll tell you my hardest clients. My hardest clients are people who have been on a million medicines for the last forty years. If people have critical thinking skills, they're going to do well with ketamine. If, you know, and I always ask people, I'm like, What's your profession? If they're like, Come a surgeon, I'm like, you'll do great. You know, because they have the skill sets to be a constant and have variables. You know, so it's like if I go into work today, this is what I'm expecting to do. baseline, but you're gonna have all these variables that you're gonna have to deal with. And that's what ketamine does. It gives you a base, but then it gives you variables. And then I tell people it's data, right? It's just data that comes up and there's no narrative attached to it. So if you can see the data, then you can reframe the narrative. But the issue is sometimes the narrative goes first and then we have the emotions secondary. And and that's a big piece of it. But people that are hard are The people that don't expect I know this sounds crappy probably, but it's the people that don't expect to have emotions. so you know, we're expected to have all emotions, right? Joy, despair, love, sadness, all of That's life. People who so I I treat a lot of people who have addictions, you know, and and I and they they make a emotional connection with a substance, right? And that substance will come when they need to. So it's given them a certain sense of control. When you start drinking or having a sex addiction or whatever else, your emotions go to that addiction. So you don't have normal emotions. So they stop making emotions. That's why people that are sober or you know, who are who are trying to be absent or whatever else. Sarah Harding: Mm-hmm. Katie: It's so hard for them because they feel emotions and they don't know what to do with them. So, so you have to normalize with people. Like it's okay to feel sad. It doesn't mean that you need to go drink. It doesn't mean that you're depressed. Sadness is normal. And and and what kills me is in the mental health space, we're so freaking smart that we think that it's cool to make mental health feel unreachable. Sarah Harding: Mm-hmm. Mm-hmm. Katie: So, you know, so I I try when people are like, I feel sad, I'm like, what did the sadness feel like? Did it feel like true sadness? Were you crying over something? Did it feel like despair? Did it feel like hopelessness? Did it feel like you were grieving something? Like what did it feel like? So I try to figure out what tangible action is this feeling actually coming from? b 'cause I believe it's all connected. We just had to figure out where it's coming from. But Sarah Harding: Mm-hmm. Katie: You know, but but but that's that's the biggest piece. I mean, if i if if you have people that are, you know, on five to seven milligrams of Xanax a day, gosh, they're hard. There's nothing there. It's like n nothing. Yes. Sarah Harding: Because they've not experienced they've been like muted, right? And so they're just here and so they don't know how to experience any shift from that. Katie: Yes. And it's all blocked, right? So but if you give me a veteran who has anhedonia, like all day long, I can help them to get their emotions back. And then we can start to understand them. So I'll tell them I'm like Again. Again. But but but you know, but it's the thing about it, right? Is like you have to you have to understand it before you can agree or disagree with it. Sarah Harding: Are you talking to me? Erin Sheffield: yeah. She's veteran. Katie: And a lot of times people are trying to either promote or suppress. No, stop. You know, and and the thing, and I tell people too, the law of conservative energy, right? Energy is not created nor destroyed, it's only transferred. So if I'm sitting there and I'm like, I don't know why I have so much fear. I'm not a fearful person. Like, I don't want to have fear. Like I, you know, and you're focused, right? You're focused so much on not being fearful. I'm like, what's the opposite of fear? Right? And believe it or not, the opposite of fear is love. And I'm like, So why don't you go over here to the love section and let's think about how can I love myself? How can I love others? And if your brain's truly, right, if it's truly doing Newton's laws of physics where every action has an equal and opposite reaction, if it's going to the polarities and it's staying at the polarities until you can build that critical thinking spectrum. Like if you're over here, build over here and then move, move your little ball to the middle to where it's neutral. And that's why I'll tell people: I'm like, you know, I want you to feel so neutral that when you're sitting in the middle, You see far right Republicans and you see far left Democrats and you think, my gosh, each of them have excellent viewpoints. That's what you want, right? And that's what talk therapy is about is trying to get people to see the far right and the far left. That's it. And ketamine will shove them right there in the middle. And you know, it's because people will be like, I don't know how to meditate. I'm like, don't worry, you'll get there. You know, so they're sitting there like, I'm not connected to anything. And exactly. That's the goal. Sarah Harding: Mm-hmm. Katie: Cause depression, anxiety, trauma, it's all become narratives to protect you. And protection isn't always good. So if we can make you neutral, you know, and I I've actually been using this analogy a lot lately, to where because my brain thinks in pictures, I'm much better with pictures than words. but I'll tell people, you know, say I if I have a female and I'm like, I want to protect her. I'm gonna put her in this bedroom forever and I'm gonna bring her food so she's safe and she has water. It's like, no, that's abusive behavior. You might think it's protection. Erin Sheffield: Mm. Sarah Harding: Maybe. Mm-hmm. Mm-hmm. Erin Sheffield: Yeah. Katie: But you're abusing the person. So so you've got to disconnect Sarah Harding: Yeah. Katie: from it. And then you have to, but people are they're so it's so interesting. That brain, either with anxiety, it gets stuck in the future, or with depression, it stays stuck in the past. And those become the protection. So if you detach from that and you sit in the present and you go, my gosh, this is the first time I've ever been able to feel peace and calm since I don't know when. Sarah Harding: Yeah. Katie: The brain can then duplicate that. It's just like muscle memory. It's behavioral memory. We all have behavioral memory. you know, but but a lot of times those behaviors that once served us are no longer serving us. But your friend that you were talking about, this is one thing I loved about her because I had no idea that she was a oral surgeon. No idea. And when she came in, I was like, She doesn't sound like an oral surgeon. You know, because you all have like surgeons, you naturally have this power. Like, period. You just do. Session three. I was like, I heard her come in. I was like, there she is. I could she was projecting this sense of confidence. And I'm like, there's the oral surgeon right there. She's doing better. Like I could just tell just from that, because she came and she was just so defeated. You know, and and that's what happens is people come to us and they're like, You're my last hope. Like, you know, I I we get I get people who are like, I am there's I'm scheduled for, the Sarah Harding: Yeah. Katie: Physician assisted suicide, you know, in the Canada, the Netherlands are like, You're my last hope. And I'm like, All right, come on, let's go. You know, so we get a lot of those, but you know, the crabby part is like, why do we have to go there? Like, why do we have to be that bad? Can you please come to me when you're like, I have not slept well in two weeks? I'm like, perfect. I don't get those yet. I get the ones who are like, white flag. Help. Erin Sheffield: Mm, I guess. Sarah Harding: Right. Erin Sheffield: So those of us Sarah Harding: Yeah. Erin Sheffield: who want to come and see you, not all of us have access to Academy and Clinic. Maybe we just have really fallen in love with you and we would love to come see you. Is it something where I have to come for two weeks and do the whole protocol? Do I benefit from getting a couple sessions in while I'm there? Katie: Yes, come on. Come to Knoxville. Erin Sheffield: What do you talk to what's what's the recommendation for people who wanna travel to see someone like you or another clinic that they trust somewhere else? Katie: I love that. I you know, I would I always tell people try to do the six, but if people wanted to come to me and you know, some is better than none, period. Right. So people could come and do two, you know, over a weekend or whatever else, because we are open six days a week. then you know, then that way they can at least see the base as to what to expect. And then if they wanted to go somewhere else, you know, and the Canamie community is a pretty small community. I mean, I've been around long enough to where I know some of the people. Or if any if anything, they'll at least talk to me typically. So we work in collaboration with a lot of clinics. but we've had I've had people fly in from Washington or Hawaii, for treatment. Erin Sheffield: Do you think is it the timeline that's more important or the number of sessions? Like if you did six sessions total over over six months, is that going to have a benefit? Or is it like the two weeks, the three weeks is really what matters the most? Katie: So right now the recommendation is to six over three weeks. I'll tell people six over four weeks. but it's it's the time frame. So so what's happening from a physiologic standpoint, ketamine peaks when you're giving them half a mig per kilo, it peaks at 40 minutes. And what it's doing is it's partially antagonizing your NMDA receptors. And when it does that, you get an excess of glutamate. Glutamate stimulates something called BDNF, the brain-derived neurotrophic factors. Those continue for the next 48 hours. Sarah Harding: Okay. Katie: So what you're trying what I what I'm trying to do is I'm trying to re stimulate that. It's almost like a loading dose. I'm trying to re-stimulate that that process once every two to three days in order to truly get the the physiologic benefit from it. Do I think that people could benefit from one time if they had a great base of meditation and understanding all that? Absolutely. You know, and hopefully the book when it comes out, that would that will help people to to guide them. Erin Sheffield: Mm. Katie: 'cause it's pretty complex. simple, but complex. But yeah, no, I all day long people can come here or I can talk to whomever across the country. Erin Sheffield: Yeah. So interesting. Okay. Yeah. Well, it's been such a joy and so fascinating talking to you. Can you tell people how we find you? Do you have an online presence? How do we find your clinic? What can we do to keep up with you more? Sarah Harding: Yeah. Katie: So revitalist.com is my website. But I am on Instagram a lot and Facebook with videos. I do my ninety second videos talking about something and Instagram keeps changing their algorithm to try to incentivize me. So you're gonna see more of me. 'Cause I've learned if I don't do it they Erin Sheffield: It incentivizes you. Me, I'm like, I'm done. Katie: Yeah no, let me tell you, here's my eight and a half years of experience. Now if you don't do it, they will make your profile more private. If you keep doing it, they make it bigger. It's yeah, it's not fun, but yeah. So when people are like, Why are you so narcissistic doing all these videos all the time? Instagram makes me do it. But yeah, I'm catwalk one two one seven on Instagram. Erin Sheffield: Yeah, sure. Katie: and then actually I had a had a ketamine video get like I don't know twenty two shares yesterday, which was pretty big. but social media, I mean people can call. I've got a guy named Mario. Everybody loves Mario and Mario will he'll hook up and connect whomever he needs to to try to get people help. but yeah, they can call they can always call. Sarah Harding: Yeah. And you can go anywhere, but you only get Adonis if you go to Revitalist. Yeah. Yeah. I'll share pictures of Adonis also. Erin Sheffield: Found you. Katie: That's right. You only see there in my and my my red dress. yeah. I do have it, yeah. I've got Aaron, I've got rescued great Danes and Adonis is a big boopy. Erin Sheffield: so cute. So cute. I see, is he the grey one? Sarah Harding: Big boy. Yes. Katie: That no, that's that's Max. You'll have to scroll down or I'll I'll send Sarah Harding: Don't worry. I'll Erin Sheffield: wow. Cute. All right, I'll find him. Sarah Harding: put it up at the I'll put it as one of the video covers. You're gonna love it. It's gonna be great. Katie: There go. Sarah Sarah's Erin Sheffield: Cute. Katie: got it. Yeah. But yes, we also have dogs. that's that's probably it's probably not the cat. I mean, it's just the dogs. Yeah. But I thank you so much for having me. Yeah, I really appreciate it. Erin Sheffield: Cute. Okay. Sarah Harding: Mm-hmm. Maybe. Yeah, maybe. Awesome. Well, thank you so much. Yeah, this has just been great. And Erin Sheffield: Probably you're probably right. Yeah, we appreciate it. Sarah Harding: it's eye opening. And I just hope that it becomes more and more of an accepted alternative therapy. And stop with the thirty five thousand dollar treatments if you can just do this. I mean, it just is insane. You know, so and after having witnessed it in person, not on myself but on someone else. I'm just converted. I'm a believer. Katie: Cities. Come on. Yeah. Erin Sheffield: Okay, can I I can I tell my crazy ECT story from residency last thing for all the people waiting till the end. So this woman, she was having these delusions, like satanic delusions. And she thought like Satan was after her and all this like scary stuff. And so you're right. He's after all of us. Right. Sarah Harding: Yes. Katie: Please. Sarah Harding: He is. He's always after you. She wasn't wrong. Katie: Is Erin Sheffield: So she was getting ECT therapy and they put the bite block in, but she had an all on four bridge on the bottom. So for people don't know what that is, she had dental implants that were supporting her teeth and there were some gaps. And so when her tongue thrust forward because of the shock, it shoved the tongue through the implants and completely split her tongue down the middle. So she woke up with a forked tongue. And they're like, this is exact wrong person to wake up with a forked tongue because she is already like freaking out about like satanic forked tongue imagery stuff. So they're like, Can you suture this up? So there you go. Let's stop doing that and let's do ketamine instead. Katie: Base a. Sarah Harding: Yeah. And I'll Katie: Hey, your story just stopped it all right there. That was beautiful. Sarah Harding: Yeah. Here it was. Yeah. I'll follow up with my less my less exciting story because my ketamine story when I realized how powerful ketamine was was I was on my anesthesia li rotation at Parkland and we did a lot of inmates and I remember waking one of them up and it was a really nice wake up and he says, Doc, you gave me some of that special K, didn't you? And I was like, how did you know? You know. Erin Sheffield: I was like, I have a story for this. I forgot until now. Sarah Harding: I had no idea. I just am so naive. I had no idea, but I was like, this must be something pretty special. So it's no forked tongue, but quite an endorsement. Katie: Did you Erin Sheffield: I mean they call it that for a reason. Right? Katie: He said he knew all your secrets. Erin Sheffield: Or the horse tranquilizer, they always call it that too. So anyway. Sarah Harding: yeah. Katie: Yep. Sarah Harding: Yeah. Katie: Well and I tell people, here's a tidbit, it's horse tranquilage and cat volume. It's used on all of our pets because it's so safe. It's not gonna kill ya. Safety. Exac exactly. No Matt Perry Matthew Peridos is here. Erin Sheffield: Yeah, that's true. That's a good point. That's a good point. And we're hopefully not giving you the horse dosing, so it's even more safe. Sarah Harding: Yep. Gonna use that one, add it to the list. Right now. Yeah. Yeah. Yes. Erin Sheffield: no. Okay. Well, thank you so Sarah Harding: Don't do that. All right. Erin Sheffield: much for joining us. Another episode of the Resting Stitch Face podcast. As always, please like, share, and follow. And we'll catch you next time. Sarah Harding: See ya.