A New Meet Delic Podcast Panel: Peace, Love & Ketamine

 Combine that with ketamine. And then while we're doing that design protocols where people at a, a social, emotional, family and spiritual level start to recreate and retell their version of, of their own heroes journey and how they have a chance to overcome. You're listening to a Bio Reset medical podcast with Dr.

Cook. If you have questions, we'll wanna talk more about your symptoms and issues. You can always reach us at 650 888 7950. The following is a discussion with Jackie Stan from the Delic Radio podcast. All righty. All righty. Let's get into it, guys. Um, We're going to do our panel with our All-Star lineup.

Uh, we're going to, uh, ask you guys for questions at the end and give the panelists a chance to speak with you guys. We're also going to do some firsthand accounts, one-on-one accounts, uh, about ketamine and how it's helped people, um, on the live here today. Um, first and foremost, we have, uh, Dr. Matthew Cook and Barbara Brenneman.

They're the founders of Biore Reset Medical. You've heard Doc and I speak, um, on Delic Radio several times, and you'll hear it in the future. Go check out, uh, delic Radio, of course, and we have Dr. David Ffel, who is the founder of Edema Neuropsychiatry Institute. You have also heard Dr. Ffel on Delic Radio.

We have the lovely Angela Ward, who was an RN and founder of Guardian at the Gateway. And last but not least, for this round of discussion, we have Julie and Kevin Nicholson, founders of Ketamine Wellness Centers. Thank you to all the panelists for being here today. We're super stoked. Um, all right, so let's talk about quickly the history of ketamine.

Uh, ketamine is a dissociative anesthetic with strong cognitive and psychedelic effects, though popular as a recreational drug. Calvin Steven, um, first developed Ketamine while searching for an alternative to P C P. Which produced undesirable effects, uh, with its discovery. In 1962, ketamine went through a series of preclinical trials before the F D A approved it.

In 1970, it became the surgical aesthetic administered to soldiers in Vietnam, due to its relative levels of safety in comparison to other anesthetics. Additionally, ketamine has been used on patients with respiratory and circulatory issues and even made its way onto the World Health Organization's list of essential medicines.

Recently, the applications of ketamine have extended to treat depression, even suicidal thoughts because it takes, um, effect much quicker than other antidepressants and produces what we think are more long lasting results. People are stu studying that, um, as we speak, and it just, it turns out that today is World Suicide Prevention Day.

Uh, ladies and gentlemen, every 40 seconds somebody prevents, or. I would hope prevents, but actually somebody commits suicide around the world. This is a very sobering and true, um, statistic, and I would imagine that it's possibly gone up, um, since I first heard that statistic. It's very real. Uh, the different forms of ketamine that we know are iv, um, intravenous, uh, IM or intramuscular tro, which are these little guys right here, uh, nasal of course nasal spray, and, uh, powder form that you would see recreationally.

So let's get into it. Let's talk about the nuts and bolts. Why does it work? Um, Dr. Ffel, I, you have been studying ketamine in your clinic, um, for many, many years. I would love to hear you talk about, Why Ketamine works or why you have seen it work and how it works.

Thank you, Jackie. It's a pleasure to be here. Um, you know, it is funny cuz I, I, I, uh, ha had this conversation with some colleagues on a chat group, uh, uh, uh, ketamine providers and some of them were, were, um, invoking this, uh, concept of neurogenesis, which I'm sure a lot of the, uh, viewers have, uh, have heard.

Neurogenesis is the, uh, is, is creation of new brain cells. Um, which at one time, not too long ago, we thought was not possible. We thought that the brain, uh, did not actually generate new brain cells after birth. But then, uh, uh, neuroscience discovered that in certain areas it did. And ketamine is known to rapidly produce this neurogenesis.

And so it's been a very kind of, um, uh, seductive, uh, Story to describe to, to, to explain Ketamine's, uh, profound, uh, you know, uh, effects, therapeutic effects with this neurogenesis. And I pointed out to the group that unfortunately, you know, the evidence is really not that, you know, it's, it's a nice story, but, but the evidence is very mixed about whether neurogenesis has any role in it.

And I think, uh, what my point for them was really that, um, there's a lot of theories. We know, we, we know that ketamine does a lot of things in the brain, but the truth is, if we, if we're gonna be, uh, intellectually honest, uh, we don't know, uh, what, uh, you know, what the mechanism of action, uh, for, for, for ketamine is we do know, we do know, for example, some characteristics like it binds to a certain receptor called the N M D A receptor, that it blocks this receptor again, that it has these changes, both, both, uh, physiological and obviously psychological and perceptual.

Um, but, but we're still trying to figure out what is the key component, um, to ketamine and why the experience that people have with ketamine is very similar. Uh, and this has been shown in, in, in, in, uh, controlled studies, very similar subjectively to other psychedelics, but yet it has a different pharmacological, um, uh, mechanism at least initially to, you know, where, where, what it, where it binds in the brain.

Um, so, uh, honestly, uh, I could, I could, uh, I could cite several interesting, uh, provocative, uh, you know, possibilities. But the truth is, we, we just don't know. And it's a great, it's a great area if you want to be a researcher. Yes. I thank you for that answer. So honest, so true. And, um, I think healthy, it's okay that we don't know.

Um, and we do need more researchers, uh, and chemists to study, uh, ketamine and other psychedelics. Um, let's, let's take it from an anesthesiologist perspective. Dr. Matt Cook, who of course you've heard also on, we've talked about this on Delic Radio. My brother. Hello Matt Cook. Um, tell us about ketamine, why, or how, what, what your experiences with it has been.

Um, from an anesthesiologist perspective.

You guys are on mute.

Sorry about that. Can you hear me now? Yes, doc and Barb. Hello, Verizon commercial. Um, thank you. Uh, it's great to be here with everybody. Uh, the, so ketamine is actually a drug that we used as part of our algorithm in terms of taking care of patients in the operating room. And we've used it a lot for sedation.

And then we've also used it a lot as a component of anesthesia. And the reason for doing that is, is because it tends to be a pretty good pain reliever. And it's the, the one thing that is a pain reliever in all of medicine that instead of lowering the rate at which you breathe, it slightly increases it.

So it tends to have a fairly high safety profile. And, and, and anesthesiologists for years and years have been taking advantage of that. And so I've been, uh, using, uh, ketamine as part of our anesthetics in the operating room since, um, since 1988, uh, which is quite a long, a long time ago. May, that makes me kind of old.

Um, But, um, the p anesthesiologist started to notice, man, when we give people ketamine, they seem to be a lot less depressed. And so then clinics started popping up all over the country and all over the world that, uh, started to do protocols where, and these were generally anesthesia driven clinics where we would do ketamine, um, uh, uh, once a week for six weeks.

And so the out the concept was to do, uh, a treatment. And, and ke ketamine seems to clinically decrease someone's depression for about a week or two. And, and the, the effects of the, the, the psychologic and sort of the mental status changes that you get with ketamine go away in an hour, maybe an hour and a half, but then for, for a couple of weeks, people will have a, uh, antidepressant effect.

And I have a lot of patients who would come in and we would give them a treatment and they would say, I felt actually pretty darn good for a week or two. Uh, we started, uh, giving people, uh, uh, combinations of protocols where I would use, uh, a, a substance called N A D, which is a vitamin that helps stimulate your mitochondria.

Yeah, n a d. And, and the idea is that if I'm stimulating the mitochondria in every area of the brain before I give ketamine, A lot of times what will happen is the ketamine seems to work better. People have less side effects in terms of nausea or headaches or other symptoms that you can sometimes get with ketamine and, and then the antidepressant effects will last longer.

And it really clued me in a couple of years ago, I traded somebody and um, I traded them twice with ketamine and n a d in a week, and then they called me a little disappointed that it wore off. And it was like eight months, seven, it was seven or eight months later. And I was like, wow, that is like a case where with that we need to publish that because it's, it gave me an indication.

And what we're doing sort of in parallel to all of that is using that time when the depression is off to help retell a new story to that is a, uh, tells a story like, oh, and people kind of will tell me, oh, I actually see that there's a way for me to get through this. I see the light at the end of the tunnel.

And so returning the lights on in the tunnel while they're, while they're still in that kind of, uh, fragile moment and then trying to kind of reset, reset their physiology and then get them out of it. And so I think that my, my vision of the future is, is that we will do combinations of protocols that use different vitamins and minerals and strategies.

Combine that with ketamine, do that in a staged approach. And then while we're doing that design protocols where people at a, a social, emotional, family and spiritual level start to recreate and retell their version of, of their own heroes journey and how they have a chance to overcome. And, and the combination of all of that is sort of where we're working with.

But, but specifically on the one front of ketamine, my, my sense is, is that it, it helps people in very difficult situations, uh, get a handle, uh, or feel a little bit better. And often that is just the, the, uh, helps them overcome the inertia of feeling that they're in total overwhelm and, and helps them transition to a better place.

Right. So it occurs to me that we actually have four different sets of, of backgrounds here, um, all coming and utilizing Ketamine to help people in this way. Um, so I think it's useful to get Julie and Kevin and then Angela's perspective on how you guys, how you guys see Ketamine in your practice, how you present it, since we've already established that we don't exactly know why it works.

Um, but obviously it's working for you guys. Um, so I'd love Julie and Kevin. Hello, welcome. And, uh, let us know a little bit about your practice and how you seek Ketamine. Hi. Sure. I'll, uh, I'll start and then Julia will fill, fill in where I screw up. But we've been treating out in Arizona since around 2011.

Um, and then officially Ketamine Wellness Centers in 2015. Um, I'm a registered nurse by background, so I started being the clinician in the room and doing, we purely do all IV infusions. We don't do the intranasal or any of the oral. Um, that's purely a decision based on our medical directors and our ownerships, you know, um, thoughts on it.

But, uh, you know, we, we feel the same way in regards to it's unique, how it's so different for every patient. And we, we take an approach by looking at the patient prior to the treatment. We have a clinical psychologist, Dr. Ellen Diamond, who's our, one of our owners. And, uh, we do a psychological interview to look at not only depression, but all the other comorbid mental health factors that may be playing into their wellness, as well as look at their medical and their physical attributes and what may be, um, part of their journey that we have to work through.

And then we develop our program based around that. Um, I love the fact that more and more clinicians are getting into this because there is more research, there's more information coming out that will allow us to. Kind of bridge those gaps in between patients, um, treatments and see if we can get longer and longer benefits.

But one of the things that we hear a lot in the psychedelic community is set and setting is really important in making sure that the environment and the, the physical space, when somebody is going through their treatment and getting into that psychedelic realm, that they feel safe, that they feel comforter, comf, comfortable with the person that they're, that they're with.

And so they can go calmly through that experience and make sure that they don't have to feel so tethered. So I don't know if Julie has any, any other thoughts, but Well, set and setting I gotta tell you is, uh, It's so important. Yes, we talk about it a lot in the psychedelic space, but it's very useful in other avenues of people's lives.

It's really about being mindful present, right? Um, and setting intentions for yourself and keeping yourself safe because as we say, a deic safety is cool. Um, right. And that's really what I wanna talk about next is safety. Um, quick personal anecdote for me in ketamine, I am, I use ketamine as a patient, uh, with an anxiety disorder and depression.

I. The first time I used ketamine was recreationally. I think I might have been 16 back in the late nineties rave culture in Austin, Texas. And I was young and did not know what I was consuming and just said yes, which is not safe. Um, and it was one of the more challenging experiences of my life. I thought I was dying.

Um, I didn't have supportive people around me. I obviously took a dose that was not suitable for me at the time, uh, was, you know, sat in the back of somebody's car alone while it, uh, while it wore off. And so I had avoided ketamine in a therapeutic setting for the next, uh, 15 years or so. And it wasn't until maybe a year ago, um, that I started to consider it in the, and, and, uh, allowed.

The fear had dissipated a little bit. And so it was, it was a beautiful thing to be able to come back to it again, um, in a way that was therapeutic and with people I trust. I've gone up to Biore Reset Medical, um, with Doc and Barb, um, to do it. And, uh, and it's helped me tremendously. Uh, and it's done more for me in a year than 20 years of psychotherapy and SSRIs did not.

Um, so let's talk about safety, because I bet there's a lot of patients who come in freaked out, not, you know, not understanding what they're going to experience. So how, um, Julie, do you guys, do you guys handle the safety aspect and then we'll go to Angela? Sure. Well, it is if their first experience with ketamine is YouTubing videos of people on ketamine, they're terrified when they come in.

So we do a lot of pre-education and tell them what they can expect. Even though it is different for everyone. We give 'em a lot of scenarios. We spend a lot of time prior to them coming into the clinic, um, talking to 'em, answering all their questions so they feel safer when they get here. Um, the, the rooms, and one of the reasons that we prefer the IV method is that you can.

Regulated. If it is getting too strong, you can pull it back, uh, slow it down, those kind of things. I'm not a clinical person, so I don't have clinical terms, so I can let Kevin speak more of the, um, the clinical part. But I, I think making sure they're in a space when they get here tremendously helps on the, how they're gonna react to the treatment.

And then having, we have one-on-one care, so if anybody does start to go a little too far and you know, just between talking them back down and slowing the infusion rate can bring it back down because it is, you know, if they said it's very safe, if it's done in the right environment, um, and done, um, therapeutically.

Right. Yeah. Dr. You know, Dr. Fel and I actually, I appreciate the timing cause we've actually collaborated on a couple of patients in the past and he's. I believe, I hope I don't mis, uh, represent, but I believe he was giving intramuscular injections for ketamine to a patient. And we dialogued about how to bridge that gap when we were converting from intramuscular to intravenous because it is a different experience and, and the bioavailability and those kind of things.

We feel because our, our doctor is an anesthesiologist, we do require our patients to be on a monitor. We do put 'em on a pulse oximeter. We do watch their blood pressure because it does cause elevation in, in, in blood pressure. And we have a chronic hypertension issue in this country. We find ourselves sometimes diagnosing unknown.

We can help make sure that we're managing that. So nice. But you still, you still want to keep it somewhat. Of a, of a relaxed setting. You don't want it so clinical that they feel like they're having it done, you know, in a, in an emergency room. Yeah. It's definitely a fine balance that people across the country are, are working on figuring out.

And because patients are so variable, uh, what the right setting is, you know, again, we're still figuring that out. We don't know. Um, but it's nice to be in an office with, uh, medical professionals who can help if something bad goes wrong. Angela, you have you practice up in the Pacific Northwest. Um, tell, talk to us about how you see ketamine and, and how you deal with, you know, while fear is not necessarily a sustainable motivator, it's still, we experience it, especially when it comes to, to very strong substances like ketamine.

Absolutely. First of all, thanks for having me here and it's so exciting to hear how everyone is working with this medicine. It's really fantastic. Um, from my perspective as a registered nurse, I'm very much in alignment with the helping the patients find their own healing path. And, uh, we have to understand that depression is not caused or not healed by drugs.

It's healed in relationship and connection. So I love what everyone said about prep and integration and providing support and care for people as they move through this process. Um, It's concerning to me, however, that ketamine is the litmus test for psychedelic medicine as it moves forward into the future.

And I'm much more interested in a psychedelic model of medicine rather than a medical model of psychedelics. I appreciate that for some people, it's appropriate for them to be in a more high, uh, high care environment. Maybe they have higher risk factors and need to be more in a clinical setting. Yet many people are, have a lot of trauma that they've experienced in a medical setting and need to have opportunities to experience this medicine in a more, um, either natural environment or home environment or more like a therapist office.

So that's how I tend to work with people. I work in conjunction with the clinic where we do Im, uh, which I think is really nice because for certain people having an IV attached to their arms and, and having a heart monitor and all that can be really anxiety producing. And it sometimes can be really nice for people to be medically cleared.

Uh, have medical professionals available if we need to intervene. But for the most part, as everyone said, it's quite a safe medicine. And then I work with my, my clients with lozenges or trophies, and that is a really lovely way to work. Yes, those are fantastic because

I am concerned that as psychedelics become more, uh, available to the public, that people are going to becoming, I self-identifying that they need to use a particular drug to heal. It's important to remember that psychedelics are tools for transformation and healing, but they are not responsible for the transformation itself.

Um, it's really important that people have a supportive environment and maybe. You know, hopefully when we have M D M A and psilocybin and some of these other things that the providers can identify what might be the appropriate treatment. But it's not just that, which is absolutely why, um, uh, was it, uh, Dell, or I can't remember who was saying Dr.

Cook maybe that people were having great antidepressive effects at the beginning of treatment, but then it wears off so quickly and it's absolutely true that people do need to rewrite their story, but they need a lot of support in that process. And so what I do as a nurse is I work with people on building in basic life skills of how to rewire these patterns into action in their everyday life.

It's a key component of integration work for any psychedelic therapy. So, uh, I've had great success with people in that way. I also wanna speak to some concerns. I have room access. To this medicine, I find that there's a lot of people charging a very high dollar amount for therapies and treatments, which is leaving out a number of people that just don't, cannot afford this medicine and can't afford this therapy.

The great thing about ketamine is it's very inexpensive and, um, yet people are paying thousands of dollars to, to have these treatments. Um, I do love that Ketamine Wellness Center does seem to offer you guys offer a sliding scale or first responder, uh, discount, which is great. Yet, um, it's still quite expensive and I'm also concerned that there's not a lot of people of color or marginalized people that are offering these services to care for those, uh, people that need that kind of support.

So I would really love a call for more access in different ways that our less expensive. And that also are offered by therapists that have some background in trauma-informed care, that have some cultural sensitivity training and can do this over a period of time. Yeah, definitely. Access is, access is key.

And it's complicated, right? We're at the beginning of, of this journey here. Um, and with more demand, I believe will come greater access to people. And um, but also going back to something you said about definitely how ketamine or psychedelics are not the answer, ultimately the patient is the answer I think, to themselves.

And, um, and it's important also that we have practitioners who can provide other technologies outside of ketamine to help, um, heal somebody's, uh, gut biome, for example, which has a lot to do with. With health and depression, um, pretty much everything to do with it. Um, so it's not just ketamine. And I think that, uh, where more studies, um, will happen, we'll have greater access, but totally heard on the access thing.

Angela, thank you so much, um, before, and we'll come back to that too because I know you wanted to talk about the Esketamine, um, and insurance. But before that, we have a couple of questions I'll, I'll give to the panel from viewers. Um, a lot of people asked about interactions. Uh, what other drugs can ketamine or should ketamine be mixed with or not mixed with?

That's a very complicated question. Um, does anyone on the panel wanna take that? Uh, Dr. Fel, we haven't heard from you in a minute. Do you wanna answer that? Sure. Um, the truth is, um, there's, there's been, um, some evidence that, that, that certain drugs may interfere with the ketamine effect, may, um, uh, may mitigate it.

Um, for example, um, there's, there, there's been, uh, uh, some evidence that, um, a drug called Lamotrigine, which is a, um, also goes by the, uh, brand named Lamictal. Um, which is, uh, which is a mo, a anti epilepsy drug, but also even more commonly used as a, as a mood stabilizer and sometimes, uh, antidepressant, um, um, can, uh, can mitigate.

The effects of, um, uh, of ketamine. Um, and, uh, but that's in clinical experience speaking to a lot of people. I would say in my own experience, um, that's not been borne out, uh, very well, in fact, and one of the strange things that, uh, that a lot of people who cite it was a small, a small, a small paper, uh, uh, uh, reporting on some case reports.

Um, but, uh, it was interesting about that study. Was it, it it actually mitigated the experience of the, you know, the dissociative experience, the psychedelic experience. But actually did not mitigate, in fact, enhance the antidepressant effect, which is very, uh, an interesting, unusual, and part of my interest in, you know, what, to what extent, uh, you know, is the subjective experience, uh, related to the antidepressant effect.

It's, you know, uh, I think we, uh, we think it's important, but we don't know exactly. There's, uh, there's some people who feel that taking a benzodiazepine, that, that would include drugs like, um, you know, Valium and Xanax and Klonopin and Ativan, um, can interfere with, uh, with a ketamine effect. And, um, that's also, you know, for none of these things I should say.

Is there a clear cut, scientific, the jury is out on these, but, um, But for example, in that latter case, um, I have found that a lot of my colleagues, uh, agree that actually it really depends on the situation that, that, that a benzodiazepine can actually enhance the experience and the therapeutic effect in it.

It, when given in the right time, For example, a patient who is a, a, a first treatment, extremely, extremely anxious about it. And, uh, and, and we feel that that anxiety, you know, is not sufficiently, uh, addressed by non-pharmacologic. You know, we, we have a, we have a great team that can really, uh, uh, work with people to, to, to reduce their anxiety.

But sometimes it's just so strong that we feel that it would be counterproductive to do the ketamine in that state. And so, in those, in those states, we found that, um, uh, pre-treating them with a, with a, uh, benzodiazepine actually can turn, uh, the experience into a much better one. So I would say there, uh, in summary, I don't wanna go through all the, you know, the list of things.

I would say that there's no, uh, there's no drug that is absolutely, uh, a no-no to combine with ketamine. Uh, there are some, some things that, uh, might have some, some, uh, interaction effects. But in, in the, but in the right, uh, circumstances with somebody who's very knowledgeable, um, it, it, they could be fine and even, uh, beneficial.

Got it. Wow, that's super interesting. Um, alright, let's talk about dosage for a second. Here's from a viewer. Um, Amee Delic viewer, uh, ketamine infusions gave me my life back after being bedridden from complex regional pain syndrome. I started October, 2016, and the dose that works for me is about 500 milligrams over five hours.

Most treatments are very expensive to Angela's point. Um, although I'm lucky to get mine through Kaiser for just my copay. Amazing. Um, is there any evidence for low dose versus high dose, or does it depend on what's being treated? Barb? Um, I let you have tons of experience with this and you also bring an interesting approach with your, um, history of Qigong.

Um, what are your thoughts on dosage?

You're on, uh, you're on mute.

Just there you are. There we go. Hey, um, Thanks for the question and also thanks for all the speakers and thank you Stacy, for that lovely break to kind of set the, set us into rest and relax here while we have this conversation because I think, uh, that's one of the things that ketamine tends to allow people that space.

Um, and I think in our, our experience in the clinic, you know, there is a standard therapeutic dosage, which is. You know, the body weighting kilos divided by two, um, for, you know, people with no contraindications. And, uh, many times with, with novice people who haven't done ketamine or with people who have lots of anxiety, um, one of the beauties of the IV therapy, uh, is that we can control the drip rate.

So we can start them off very slowly, create an atmosphere where they know they're in the safest place on earth. Um, I find a lot of energy medicine things, meditation, such as we did with Stacy, um, will help people to get into that space. One of the things people with anxiety do is say, I don't know what to do right now.

What should I be doing? And so doing deep breath work, you know, just doing things to get them in their body is super helpful. Um, and just sort of all the things that we've learned from yoga and Qigong about how to be present and be in our bodies. And then the disassociative effect of ketamine allows once you're present and feel safe, you to be able to release some of the, uh, things that are creating that fight or flight, and cr you know, can be based on trauma, et cetera.

So, You know, my general feeling about dosage is that, is that, uh, less is more, particularly when you're beginning. Um, but you know, then you have the other end of the spectrum with someone that has chronic regional pain syndrome and they need a big dose because of what's going on with their nervous system.

Um, but for many people, even this sort of psycholytic dose where you can stay in a very relaxed interactive and let the patient decide how interactive they wanna be in that conversation. So, you know, it can range from, you know, they'll talk a lot at the very beginning and then get into the experience and be cool.

Or some people will wanna talk through the whole conversation or halfway through the, through the, you know, maybe 25 minutes in they'll be like, okay, I just hit something. Could you hold my hand for a second? Just let me know that I'm safe. Could you just ground me? So there's a lot, and this goes to set and setting, but also presence.

And I think, you know, for me, one of the most important things is making sure that the person that is with the patient is staying super present. So, you know, there's no looking at your phone, there's no texting or thinking about other things. And that's a wonderful exercise for the therapist as well, because they get the benefit of that meditation and that healing experience.

So everyone gets healed in that experience. And then the second point I'd like to make about dosage and about effectiveness is that if you can give people homework, I mean, as somebody who taught yoga and Qigong for a long time, I know that. You know, it's hard to establish a pattern of taking care of yourself, but self-care is so important.

Even if it's just two minutes or five minutes a day and it takes it out of, I'm giving you something to fix. You, poof, you're fixed. I just baked your cake. Your cake, right? It doesn't work that way. You have to actually have some accountability and continue on with your therapy in between the sessions and so, you know, whether it's, you know, let's work with a set of affirmations, a set of intentions, and you know, have some accountability back and forth.

The medicine, the effect of the medicine will work. For longer and we'll work more effectively. And, um, so it's not just about come in, do the medicine, feel better, don't feel better. There is like a, because eventually you want, you wanna not have to need the medicine anymore. We get asked that question a lot.

How many sessions do I need to do? And the answer is, we'll figure that out as we go along. Let's do one and see how you do. You know, the studies are on six sessions or on 12 sessions and, but those are on specific conditions and people are so different. So I guess I view this whole ketamine therapy as just another amazing tool in how you could use all of the sort of mind body tools to help yourself.

Live your best life. And then I'll tag on that. That's a very good question. And it's, um, I think relevant on a number of fronts. And it goes back to the dos