Trauma is Complicated but Can Relief be as Simple as an Injection?

Trauma is Complicated but Can Relief be as Simple as an Injection?
By stella
04th Apr 2022

Post-traumatic stress is a prevalent and debilitating condition that doesn’t discriminate against anyone. According to the National Center for PTSD, about 6 of every 10 men (or 60%) and 5 of every 10 women (or 50%) experience at least one trauma in their lives. Regardless of their age, race, gender, and religion, anyone can experience post-traumatic stress. 

PTSD is a mental health condition that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault (1).

At Stella, we replaced “Disorder” with “Injury. “Disorder” connotes a sense of permanence which is misleading because PTS is treatable. Disorder can also lead to the stigma that can prevent those who need help from asking for it. We speak more about this in our post, “What is PTSD?”

The Family Tree of Trauma

PTSI can be categorized under several main types of trauma.

  • Acute trauma: A single stressful or dangerous event.
  • Chronic trauma: Repeated and prolonged exposure to highly stressful events. 
  • Complex trauma: Results from exposure to multiple traumatic events.

PTSI can come after experiencing events like war, sexual assault, adoption, and domestic abuse to name only a few.  It encompasses many different mental health conditions, like suicidal thoughts, depression, and anxiety. But because of the stigmas surrounding PTSI, over a quarter of the American population believe it is untreatable.

Current treatments that exist for people experiencing trauma symptoms can be classified as pharmacological therapies or psychotherapies, including cognitive-behavioral therapy (CBT), cognitive processing therapy (CPT), prolonged exposure, hypnotherapy, and others. Success rates for singular therapies remain inconsistent and, or many, the formula for lasting relief combines biological and psychological interventions. Because of this, clinicians are exploring new options.

The Innovative Options

A study released earlier this year by Stella’s Chief Medical Officer, Dr. Eugene Lipov, Stella’s Chief Psychologist, ​​Dr. Shauna Springer, and other trauma experts concluded the Stellate Ganglion Block is an effective treatment for PTSI symptoms no matter their gender, trauma type, PTS-related drug use, history of suicide attempts, or age.

Out of the 327 patients were included in the final statistical analysis, an overwhelming majority of them experienced relief in PTSI symptoms after the Stellate Ganglion Block treatment. The patient population included 132 civilian females, 13 military females, 85 civilian males, and 97 military males. 

The Results

Dr. Lipov identified 21 types of self-reported trauma leading to PTSI for the individuals involved. Among the 21 types of reported trauma, 19 types reached statistical significance.

The PCL was used, which is a self-report assessment that determines symptoms, screens, and monitors changes before, during, and after PTSI treatment. There was an average decrease in PCL score was 28.59 and 29.2, respectively. The men and women who had a military background had a significantly greater reduction in PCL score than civilians.

Overall, the study concluded that there was a statistically significant improvement in PTSI symptoms independent of the causative trauma type, gender, age greater than 20, previous suicide attempts, or use of prescription medications for PTSI.

While people experience symptoms caused by emotional trauma differently, we all have one thing in common – we are looking for relief. The Stellate Ganglion Block treatment appears to hold promise for both women and men, with both military and non-military traumas.

Post-traumatic stress can be treated as an injury no matter the complexity of the trauma.

Is the Stellate Ganglion Block Right for You?

The Stellate Ganglion Block is a fast, effective, and research-back treatment and when combined with talk therapy, and other mental health solutions recommended by your providers, can be the new standard of care. Stella simplifies the healing journey. Our PMHNP experts will review symptoms and medical histories to determine if the Stellate Ganglion Block (SGB) is the right treatment plan. More than 80% of Stella patients find relief from their PTSI symptoms. If you are interested in learning more, please contact us directly by calling 1-866-497-9248.

  1. https://www.ptsd.va.gov/understand/common/common_adults.asp

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Cost, Care, and the Need for Transparency: A Statement From Our Co-Founder

Cost, Care, and the Need for Transparency: A Statement From Our Co-Founder
By stella
28th Mar 2022

This article is written by Stella Co-Founder and Chief Strategy Officer, Michael Gershenzon. 

As the Co-Founder of Stella, I’ve got something to say.

The team at Stella is comprised of over 50 full-time employees who come from varying walks of life. Each employee has a unique background and personal story that led us all to where we all are today. They could be doing just about anything with their careers – working at Fortune 100 companies, bolstering their resumes and enjoying luxurious company perks.

But they chose Stella.

They chose a risky, small start-up born during the chaos of COVID-19 attempting to bring to market the first new FDA-approved standards of care for mental trauma sufferers in over 2 decades.

And Stella chose them, along with everyone else who would come under our care. 

The people at Stella are grappling with a conundrum that our clients are also feeling. We’re all asking ourselves:

“Why are these treatments so expensive and why won’t insurance help?”  

Myself, our C-suite and our board have been trying to crack this since inception. As the Co-Founder, I’m going to attempt to very directly answer these “why” questions below.  

The responses are probably unsatisfactory… but true.

Health Runs Through Insurance Companies (and The Government)

For better or worse, the US healthcare system revolves around health insurance companies which serve as the arbiters of what care you can receive (and don’t receive).  At the risk of oversimplifying, we need three ingredients for a treatment to be adopted by insurance:

  • A government agency (i.e. the FDA) signing off the treatment is safe and effective
  • Proof the treatment saves the insurance company money. In many cases this is by offsetting an existing cost elsewhere. The cost of trauma, depression and anxiety are enormous, however they are often indirect (lost productivity, absenteeism, etc..) as opposed to an existing direct insurance cost.
  • A bureaucratic process that entails pitching and contracting with each insurance company to convince them to include this as a benefit for their members

The median cost of FDA approval for a new drug is $19 million.  The process from pre-clinical testing to FDA approval takes an average of 12 years for a drug and 7 for a medical device.  While that time passes, people suffer and in some cases die.

Importantly, the absence of FDA approval or insurance coverage does NOT mean a treatment is not effective. There are roughly 10,000 approved therapeutics for roughly 10,000 individual diseases but once a drug is approved for one condition its often not approved for others where it can be beneficial. A few common examples include:

  • LASIK for Vision Correction (FDA approved but not covered by insurance)
  • Aspirin for Cardiovascular Disease Prevention (not FDA approved for that indication)

Mental Health (Let Alone Interventional Mental Health) Is Way Behind

Despite the jaw dropping impact to the US economy ($210+ billion from depression absenteeism alone, according to the APA), immeasurable personal and familial suffering, and very measurable loss of life (death by suicide is the 10th leading cause of death, according to the CDC), mental health is decades behind other healthcare fields in terms of medical innovation and even willingness to acknowledge the problem. 

As humans, our most important organ, the brain, is one of the least understood. The complexity of the brain and relative astronomical cost of brainscan technology, like fMRI, have put research and innovation in this space on the backburner.

You can see physical symptoms of disease.  You can see a broken bone.  You can see cancer. You can’t readily see mental trauma without a brain scan (see point about its uneconomical cost above).

It’s no wonder why society generally views mental afflictions as “something just in your head that you can tough through.”  

In this context, it may be easier to understand why proven treatments have been forced outside of insurance and FDA adoption.

While the Stellate Ganglion Block (SGB) for trauma and acute anxiety, ketamine infusions for treatment resistant depression, and other modalities have proven their efficacies, they remain FDA approved for other indications, just not for mental health.  

These treatments are administered by the same exact Board-Certified Doctors which may treat people with SGB or Ketamine for pain, but these modalities are forced to wear the “off-label” tag. This off-label tag impacts everyone involved:

  • Doctors shoulder materially more liability
  • Mental trauma survivors pay out of pocket
  • Companies fight an uphill battle of educating clients 

We’re dedicated to providing people with access to treatments that work while proving to the industry that these biological treatments are not “fringe” – they just haven’t made it through the multi-decade process of FDA approval, insurance reimbursement, and medical community adoption. 

Stella Invests In Much More Than “Just The Procedure”

For every mental trauma survivors we treat, Stella loses approximately $2,000. By the way, we’re not alone. Some companies like Field Trip Health, Novamind, Numinus, Ketamine One, Wesana, Revitalist, TrippSitter and others do as well. (They are public companies and so are their numbers, you don’t have to take my word for it). More on this later.

Unfortunately today, there is no singular “mental trauma cure.” Individuals’ paths to healing are customized to each respective person, their circumstance, their biology and their lifestyle.

What we’re building is not just “a procedure” or “an infusion.” It’s a curated whole person care model which encompasses medical, behavioral and social determinants of care (which may involve a procedure or infusion along the way). Stella pairs biological modalities with psychological ones to ensure the most effective, lasting outcomes.

In some ways, you could compare Stella’s approach to mental trauma treatment to tearing an ACL. Treatment for an ACL tear often looks something like this:

  • Surgery to repair the torn ligament
  • Appointments with qualified doctors to verify all is healing appropriately
  • Medications along the way to manage the pain
  • Months of physical therapy to relearn to walk
  • Crutches to aid your walking while you rebuild strength

We follow a similar blueprint for mental trauma relief.

Stella provides a biological intervention to heal the injury caused by mental trauma, pair it with trauma-informed therapy for reintegration, provide self-help tools to manage the pain along the way, and recommend a support system to ensure you maintain the gains. This is all wrapped up in dedicated compassionate care coordination that guides your journey from beginning to end.

This may shed light on the earlier point – “how is it possible Stella loses $2,000 per treated patient?”  The simple answer is – we don’t exist to “transact a procedure.” Matter of fact, you may be able to get that cheaper somewhere else. 

We’ve invested in 360 degree care coordination that leads to outcomes previously unfathomed. 

This is all on the bet that one day, this will be a standard of care for mental trauma survivors. That insurance companies will adopt the new age of mental healthcare. That those we serve no longer have to come out of pocket for treatment to which they have a right.

Oh and by the way, if we don’t successfully obtain FDA and insurance adoption, we’ll likely be out of business in the next few years.

In Conclusion

We’re not able to fix the US healthcare system.  I wish we could.  We can’t.

We are able to make innovative treatments accessible to mental trauma survivors nationally (50+ locations in the US) and globally (we have locations in Australia and Israel). 

We are able to wrap these treatments in additional care and not view them as “transactional procedures.”  Mental trauma survivors need care – not procedures. 

We are able to prove to the government regulatory bodies that these treatments are objectively safe and incredibly effective for the right people and when administered by the right teams in the right settings.

We are able to prove to insurance companies that these treatments both save lives and save them money.

Unfortunately, between now and insurance reimbursability, these treatments will cost survivors too much money and force companies like Stella to subsidize losses.

We’re working hard to change that. We chose you.

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What's All The Talk About Trauma Response?

What's All The Talk About Trauma Response?
By stella
24th Mar 2022

If you are a trauma survivor, a mental healthcare worker, or know someone who has experienced trauma, you have noticed the rise in trauma awareness, especially during the pandemic. 

Data from YouGov.com finds that nearly a quarter (23%) of 18-to 24-year-olds say they’ve sought mental health counseling during the pandemic. This is a noticeable increase from April 2020, when 13% of adults under 25 reported that they had turned to a mental health professional during the COVID-19 crisis. 

The last 2 years have brought critical paradigm shifts in our views on trauma. There has been increasing acknowledgment of trauma, post-traumatic stress, and the solutions that need to be taken to support those that have experienced it. Awareness has been influenced by musicians, actors, and popular personalities.

Lady Gaga created and expanded her Mental Health First Aid for teenagers in high schools across the country. Prince Harry joined BetterUp, which provides coaching and mental health services to businesses and individuals. And, in his memoir Over the Top, Van Ness describes his experiences with addiction, depression, trauma, and being HIV-positive.

Over the past 18 years, Google searches for “trauma” have steadily risen, peaking in 2021, according to Vox.com’s article How trauma became the word of the decade. These spotlights are important to the growing awareness of mental health and trauma but we must continue to educate ourselves, and others, as we push forward on destigmatization.

What Happens if We Don’t Know We Have Trauma or Leave Our Trauma Untreated?

When trauma remains untreated, signs, symptoms and responses may begin to appear.

Some recognizable symptoms following trauma are agitation, nervousness, anxiety, trouble concentrating, depression and headaches. There are many more, which you can explore on our previous blog, Signs and Symptoms.

Outside of the gaining an understanding of the signs of trauma symptoms, there has been a growing movement happening right now on TikTok where users are having tough conversations around trauma and information sharing with one another. With over 110.8M views on the hashtag #traumaresponse, more and more people who have unknowingly experienced trauma are recognizing their own personal symptoms and responses for the first time.

What most don’t know is that there can be a difference between a trauma symptom and a trauma response.

What is Trauma Response?

Trauma Response is the unconscious response style we can develop in the wake of untreated trauma that shifts our previous way of relating to others or our situations. 

Trauma can change our personality. It’s response patterns reflect what trauma has taught us and how we apply these lessons to increase our feeling of being safe. However, trauma also changes our sense of identity and our relationships over time, and may themselves cause additional loss and further trauma in our lives. 

What Can Trauma Responses Look Like?

Hyper Independence 

Trauma can make us feel that our safest path is to work and live alone. We may feel like the only person we know we can rely on is ourselves and it can make us feel undeserving of connection with others. We can feel ashamed of who we have become and avoid social contact and interdependence for this reason as well. 

Overworking 

Overworking ourselves can be an attempt to outrun our trauma. It is a distraction from our trauma symptoms. When we are not working, symptoms increase because we longer have the focus of work to distract our intrusive memories. 

Lack of Memory

Cognitive changes are part of the trauma response, including memory and concentration loss. Think of unaddressed trauma as a “file” on your mental computer that slows the whole system down. While it is unaddressed, it is always running in the background. Then all of a sudden, it sends a “pop up” into your mental space – which impedes the ability to focus and remember things with clarity. 

There may also be a conscious or unconscious suppression of disturbing memories. When we suppress one thing,  we often suppress other memories as well since our memories often interlock in our memory network. 

Apologizing Constantly

Apologizing constantly can be a behavior designed to “keep the peace” and “socially appease” someone else. If our trauma is interpersonal, this behavior can develop in response to an attempt to avoid dangerous interactions. The same can happen with People Pleasing (Fawning) and Over Explaining (Fawning) trauma responses. 

Isolation 

Many trauma survivors have said for years that trauma shrinks their world. We may feel overwhelmed or unsafe in groups, quick to anger, misunderstood, or just uninterested in being around people. 

Oversharing 

Oversharing can be part of lacking boundaries when we have been violated in traumatic ways and can also be part of the anxious-ambivalent attachment style 

Body Dysmorphia 

Body dysmorphia and past trauma are only just beginning to be understood. Nevertheless, a growing body of research suggests that trauma is strongly associated with the development of BDD.

Approaching Trauma Treatment

Though many people have experienced or are now recognizing exposure to trauma, awareness surrounding trauma is growing, and that’s a good thing. Signs, symptoms and responses to trauma can come in many different forms. The more access we have to care, the better the chance of us finding relief when needed. 

There are many highly recommended treatments for trauma. In recent years, the Stellate Ganglion Block (SGB) has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that you can read more about here or learn more about SGB on our “How It Works” page.

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Case Study: Can the Stellate Ganglion Block (SGB) Reduce Symptoms of Long Covid?

Case Study: Can the Stellate Ganglion Block (SGB) Reduce Symptoms of Long Covid?
By stella
04th Mar 2022

Since March 2020, there have been 442 million COVID-19 cases worldwide. Over the last two years, we’ve learned a lot about how the virus works and how to protect ourselves against it. We’re also learning what COVID-19’s long-term impact on our mental and physical health will be.

While most people who are infected with COVID-19 recover from their symptoms in within four weeks, studies indicate that about 10% of people experience long Covid symptoms.1 Long Covid can present itself in many ways but the most common symptoms are:2  

  • Fatigue
  • Dizziness upon standing
  • Elevated resting heart rate
  • Shortness of breath
  • Brain fog
  • Sleep disturbance
  • Fevers
  • Gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea, cramping, etc.)
  • Loss of smell
  • Loss of taste
  • Anxiety
  • Depression

Research on Long Covid

Medical professionals continue to innovate as we learn more about how COVID-19 can impact the body in the long term. While early papers, case studies, and trials have provided helpful information about Long Covid, more research needs to be conducted.

Stella Certified Doctor Dr. Luke D. Liu and Research Coordinator Deborah L. Duricka recently added to this body of knowledge with their independent study conducted earlier this year, Stellate ganglion block reduces symptoms of Long COVID: A case series. This study explains how the Stellate Ganglion Block (SGB) successfully reduced two individuals’ long COVID symptoms.

SGB’s History and How It’s Used Today

SGB is an injection of local anesthetic into the stellate ganglion – a bundle of nerves in the neck – first performed in 1926 to treat chronic back pain. Almost 100 years later, SGB is still a common pain management procedure. 

In 2006, Stella’s Chief Medical Officer Dr. Eugene G. Lipov pioneered the use of SGB to alleviate symptoms of Post Traumatic Stress Disorder (PTSD) – please note that Stella prefers the term Post Traumatic Stress Injury (PTSI). Two years later, a peer-reviewed study on the topic was published.

Dr. Liu’s study offers another possible application of SGB: the treatment of long Covid symptoms.

SGB as a Long Covid Treatment

People with long Covid may develop dysautonomia, or the dysfunction of the parasympathetic nervous system. The parasympathetic nervous system regulates non-voluntary body functions like digestion, blood pressure, sweating, and more. Many with long Covid present with some these symptoms.

During SGB, local anesthetic is injected which temporarily blocks or “turns off” the nerves it’s injected into which can help restore normal biological functions. 

Dr. Liu performed SGB on two women with long Covid symptoms. After the procedure, both women reported improvement, suggesting that SGB may be able to effectively treat long Covid symptoms.

Reviewing the Case Study

Eight months after the onset of the COVID-19 diagnosis, the 42-year-old woman was still experiencing over 7 different long Covid symptoms:

  • Debilitating fatigue
  • Mental fogginess
  • Difficulty concentrating
  • Elevated resting heart rate
  • Sleep disturbance
  • Altered sense of taste and smell
  • Lack of appetite and food aversion due to changes in taste and smell

The unpalatability of food led to a 30-pound weight loss that continued to progress. On top of her symptoms, she had been let go from her job and was teaching four-hour CPR courses with difficulty, relying on her teaching manual to recall facts and procedures previously well known to her. 

After receiving SGB on her right side, she had immediate improvement in taste and smell as well as improvement in mental clarity and concentration. Two days later, she received SGB on her left side and immediately experienced more improvement to their taste and smell.

Soon after, she was able to drive home without conscious effort to recall the route, demonstrating noticeable improvement in memory. On top of that, she was able to teach a nine-hour course for CPR instructors without relying on written material, demonstrating a drastic improvement in recall. 

Two weeks later, she reported durable restoration of taste and smell and refreshing sleep resembling her pre-COVID-19 baseline.

COVID Symptoms Before and After SGB Treatment

Seven months after her COVID-19 diagnosis, the 44-year-old woman entered Dr. Liu’s office. 

Initially, her COVID-19 symptoms were loss of smell and taste, mental fogginess, headache, and shortness of breath. 

One week after the onset of acute symptoms, her headache worsened, prompting evaluation in the ER. Her headache symptoms dissipated over the following two weeks but she still experienced a multitude of symptoms:

  • Declining cognitive function
  • Developement of stuttering speech
  • Significant cognitive impairment
  • Right-sided paresis (muscular weakness)

Her symptom of paresis prompting hospitalization and evaluation. Her MRI results demonstrated inflammation and did not show signs of neither a stroke nor viral infection of the brain. 

After being discharge with ‘sequelae of COVID-19-induced ventriculitis’ as a leading consideration, she was prescribed intense occupational, physical, and speech therapy for profound memory deficits, speech impediment, impaired coordination, inability to concentrate, and debilitating fatigue. Yet, despite these therapies, she could not continue her work as a special education teacher.

Now seven months later, she had returned to work with limited duties and shortened hours with while still experiencing Long Covid symptoms: 

  • Debilitating fatigue and speech impediment.
  • Altered taste that led to food aversion and significant unintentional weight loss.
  • Severe generalized body pain described as dull with pins and needles that occasionally kept her bedbound. 
  • The acute stress and mental or physical exertion exacerbated her right-sided motor deficits, fatigue, and cognitive issues. 
  • Intermittent headaches described as “crawling pain in my brain.”

Within minutes of receiving SGB treatment on her right and left side, her taste and smell drastically improved. Three days later, her physical and mental stamina had improved significantly, allowing her to perform routine household activities without debilitating lapses in memory. 

One week after treatment, she began a new job as a high-school teacher and was able to teach a full day of classes, which she states would have been impossible prior to treatment. Two weeks later, she reported durable resolution of stuttering and 75% improvement in all other symptoms. 

At 60-day follow-up, she reported normal levels of fatigue and cognitive function, durable restoration of smell and taste, and absence of post-exertional malaise.

COVID Symptoms Before and After SGB Treatment

A Promising Future

While this has not been through any clinical studies and the only data are investigative case studies at this point, its application in treating long Covid/PASC is novel but promising. 

The lack of effective treatments for long Covid/PASC makes the SGB an attractive therapeutic modality that deserves further investigation.

Read the full study here.

1. https://health.ucdavis.edu/coronavirus/covid-19-information/covid-19-long-haulers#:~:text=This%20condition%20can%20affect%20anyone,will%20experience%20long%2Dhaul%20symptoms.

2. Soriano J.B., Allan M., Alsokhn C., Alwan N.A., Askie L., Davis H.E., Diaz J.V., Dua T., de Groote W., Jakob R., Lado M., Marshall J., Murthy S., Preller J., Relan P., Schiess N., Seahwag A. World Health Organization; 6 October 2021. A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus.

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Can Stellate Ganglion Block (SGB) Help Prevent Suicide?

Can Stellate Ganglion Block (SGB) Help Prevent Suicide?
By stella
03rd Mar 2022

Stella co-founder and leading trauma expert Dr. Shauna Springer spoke with Mission 22 to discuss the power of Stellate Ganglion Block (SGB). Mission 22 is a national community supporting active service members, Veterans, and family members through three key areas of focus:

  • Support and Treatment Programs— addressing Post-Traumatic Stress, Traumatic Brain Injury, suicide risk and other challenges.
  • Social Impact— uniting civilians and the military community to raise awareness of issues active service members, Veterans, and their family members face.
  • Memorials— remembering and honoring service members and Veterans through large scale installations and digital initiatives, while raising awareness for issues faced on home soil.

Stella believes that when biological interventions – like the Stellate Ganglion Block (SGB) and ketamine infusion therapy – are paired with psychological interventions, like Mission 22’s Recovery and Resilience Program, the result can be life-changing.

In recent years, the 17 most common symptoms following trauma have been identified. On this list includes suicidal thoughts or attempts.

We can be so overwhelmed by our symptoms that we sometimes consider harming ourselves or suicide. When we’re experiencing trauma symptoms, we can also experience depression, panic attacks, anxiety, and substance abuse and are at higher risk for suicide. In fact, people diagnosed with trauma symptoms are 9.8 times more likely to die by suicide.1 

SGB has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that indicates that the SGB is an effective treatment for trauma symptoms regardless of gender, trauma type, PTSD-related medication use, history of suicide attempt, or age.2 

  • Sleep Difficulties
  • Chronic Hypervigilance
  • Startle Response
  • Difficulties Concentrating
  • Floods of Anxiety
  • Irritability or Anger/Rage

Dr. Springer also explores a couple common misconceptions about SGB.

The first misconception is that SGB “blocks you.” This misconception is tied to the assumption that SGB is a nerve blocker, which it is not. If you’re asking yourself, “What Is SGB?” you can learn more about how it works here.

The next misconception discussed is the assumption that SGB “takes your edge away.” On the contrary, people who have received SGB by Stella have come back and reported that SGB had improved reaction time.

Listen to the full piece here:

If you are thinking about suicide or need emotional support, please text “HOME” to 741741 for free, 24/7 crisis counseling from Crisis Text Line. We want you to know that you are not alone and that there is hope. 

  1. National Center for PTSD. PTSD and Death from Suicide. Retrieved 9/28/21 from https://www.ptsd.va.gov/publications/rq_docs/V28N4.pdf 
  2. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: https://www.painphysicianjournal.com/current/pdf?article=NzM5Nw%3D%3D
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What Is PTSD?

What Is PTSD?
By stella
14th Feb 2022

If you’re asking yourself, “Do I have PTSD?” (which Stella refers to as PSTI) and think that you may be experiencing symptoms, take this PTSD test online. Or, contact our Patient Care Team directly by calling 1-866-497-9248 or emailing care@stellacenter.com.

Everything You Need To Know About PTSD

What does PTSD stand for? PTSD is an abbreviation for Post-Traumatic Stress Disorder.

And what is PTSD? In the field of psychology, PTSD is thought to occur in response to experiencing a traumatic or stressful event that creates feelings of horror or helplessness. What most don’t know is that PTSD isn’t always caused by one big traumatic event. Years of cumulative trauma can cause PTSD as well. PTSD can last for months or years, and we can experience a range of physical and psychological symptoms – we’ll explore this a little later.

When we experience trauma, our body’s fight-or-flight response turns on, and sometimes it stays on long after the traumatic event. Many researchers agree that the amygdala (also known as the brain’s “fear center”) becomes overactivated after trauma, causing nerve growth.1 This nerve growth may prevent the fight-or-flight response from returning to a normal level. Brain imagery data suggests that trauma symptoms cause changes that are visible in the brain.2

How Common Is PTSD?

Before the COVID-19 pandemic, it was estimated that 6% of the U.S. adult population would struggle with trauma symptoms at some point in their lives.3 The additional burden of psychological trauma beginning in 2020 is hard to calculate. Not only has COVID-19 impacted physical and mental health, but it’s also had serious repercussions on jobs, access to basic resources, relationships, and more.

Post-Traumatic Stress Disorder vs. Post-Traumatic Stress Injury

A growing number of trauma experts have advocated to “drop the D” in PTSD. And as of 2015, the Pentagon, government officials, organizations, and advocates have stopped using “disorder” to describe Post-Traumatic Stress (PTS).4

Dropping the D in PTSD highlights the fact that PTS may be an injury rather than a disorder.5

There are two key reasons why dropping “disorder” is essential:

  1. “Disorder” connotes a sense of permanence which is misleading because PTS is treatable.
  2. “Disorder” has a stigma that can prevent those who need help from asking for it.

The language we use to describe human experiences matters. Words have the power to make us feel isolated and stuck or understood and empowered. That’s why, at Stella, we replaced “Disorder” with “Injury.” We encourage you to adopt the term Post-Traumatic Stress Injury (PTSI), too.

What Causes Post-Traumatic Stress Injury?

Traditionally, PTSI has been linked to events such as war, sexual assault, or natural disasters. But when we consider the definition of trauma – a deeply distressing or disturbing experience – it becomes clear that many events can be categorized as trauma. Think workplace abuse, reproductive challenges, divorce, loss of a loved one, or a sports injury.

We also know that LGBTQ+ community members and/or ethnic minorities are often mistreated and/or oppressed. As a result, may experience traumas like bullying, physical violence or threat, and homelessness. These are the most common – but certainly not all – causes of PTSI today:

  • Adoption
  • Bullying or hazing
  • Childhood trauma or abuse
  • Childhood neglect
  • COVID-related trauma (e.g., hospitalization for COVID, post-COVID health challenges)
  • Combat and/or warfare
  • Death or injury of a loved one
  • Divorce
  • Domestic abuse
  • First responder trauma (for healthcare workers, EMTs, and LEOs)
  • Homelessness
  • LGBTQ+ trauma (e.g., harassment, rejection, identity crisis)
  • Loss of pregnancy
  • Natural disaster
  • Non-physical interpersonal abuse (e.g., emotional abuse by a narcissistic individual)
  • Personal health issues
  • Physical violence or threat
  • Political/ national refugee-related trauma
  • Racial trauma
  • Reproductive challenges/ infertility
  • Secondary PTSD
  • Sexual assault
  • Sports injury
  • Victim of crime by a stranger (e.g., mugging, break-in, robbery)
  • Witnessing a traumatic event
  • Workplace injury or job-related accident
  • Workplace abuse, loss, harassment, or other related workplace trauma

What Does Post-Traumatic Stress Injury Feel Like?

Anxiety is one of the most common symptoms following trauma exposures. While it’s normal to feel anxious from time to time, when we experience PTSI, anxiety often persists. We feel our worries and fears intensely. In addition to thinking about what could go wrong, we also experience a faster heart rate, heavy breathing, sweating, and feeling tired.

Intrusive thoughts, hypervigilance (or feeling constantly unsafe and on-edge), nightmares, flashbacks, and guilt can add to the sense of uneasiness we feel when experiencing trauma symptoms.

Depression is also common and is frequently identified through changes in mood. When we have PTSI and are depressed, we may withdraw from the activities we used to take pleasure in. Sometimes this is because we struggle to enjoy ourselves and other times it may be to avoid a trigger.

While the symptoms often develop immediately after the trauma or stressful event, they must persist for more than 30 days to receive a diagnosis of PTSI. Before 30 days, the symptoms are classified as “Acute Stress Disorder.” While many mental healthcare resources highlight the 17 most common symptoms of trauma, there are actually more:

  • Agitation
  • Anxiety
  • Crying spells
  • Depression
  • Dizzy spells
  • Flashbacks
  • Headaches
  • Hypervigilance
  • Nervousness
  • Nightmares
  • Obsessive-compulsive tendencies
  • Panic episodes
  • Paranoia
  • Problems with concentration or thinking
  • Problems with memory
  • Shakiness
  • Sleep disturbances
  • Substance abuse
  • Suicidal thoughts or attempts

At Stella, we work with those who have experienced a wide range of traumas. With the right insights and the right support, healing is possible.

Post-Traumatic Stress Injury Treatments

Contrary to popular belief, symptoms of trauma is treatable. Pharmaceutical drugs and talk therapy are two of the most popular treatment options. Stella is ushering in breakthrough treatments for PTSI that can rapidly relieve the worst PTSI symptoms and lay the foundation for game-changing outcomes and long-lasting healing from trauma.

You can learn more about Treatment by Stella by calling our Care Team at 908-928-4086.

  1. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD) https://www.sciencedirect.com/science/article/abs/pii/S0306987709000413
  2. Alkire, M.T., Hollifield, M., Khoshsar, R., Nguyen, L., Alley, S. R., and Reist, C. (2015). Neuroimaging suggests that stellate ganglion block improves post-traumatic stress disorder (PTSD) through an amygdala mediated mechanism. Presented at the Anesthesiology Annual Meeting, October 24, 2015.
  3. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from https://www.ptsd.va.gov/understand/common/common_adults.asp
  4. Itkowitz, C. (2021, October 28). Dropping the ‘D’ in PTSD is becoming the norm in Washington. The Washington Post. Retrieved February 2, 2022, from https://www.washingtonpost.com/news/powerpost/wp/2015/06/30/dropping-the-d-in-ptsd-is-becoming-the-norm/
  5. Ochberg, F. (2012). An injury, not a disorder. Dart Center for Journalism and Trauma. Retrieved 8/25/21 from: https://dartcenter.org/content/injury-not-disorder-0

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PTSD Signs and Symptoms

PTSD Signs and Symptoms
By stella
14th Feb 2022

If you’re asking yourself, “Do I have PTSD?”(which Stella refers to as PSTI) and think that you may be experiencing symptoms, take this PTSD test online. Or, contact our Patient Care Team directly by calling 1-866-497-9248 or emailing care@stellacenter.com.

Spotting the signs and symptoms of PTSD can be difficult. Research suggests that only 2-11% of people experiencing trauma symptoms are actually diagnosed.1 This is one of the many reasons Stella is dedicated to the education of the impact of emotional trauma and the available treatment options. We strongly believe that demystifying the impact and treatment of trauma reduces stigmas associated with PTSD.

While PTSD has been referred to as a disorder, many claim it’s an injury. Stella and others have suggested a new term – Post Traumatic Stress Injury (PSTI) – in place of Post Traumatic Stress Disorder (PTSD)2.

What Are the 17 Symptoms of PTSD?

Trauma can cause symptoms that diminish our capacity to experience warm and loving feelings from others (i.e., emotional numbness), which can lead to profound negative changes to our self-image and identity and spark fears that often limit our enjoyment of pleasurable activities. When we have symptoms following trauma exposure, we may have recurring feelings of helplessness and horror. We also commonly experience panic attacks, feelings of self-blame and shame, chronically disrupted sleep, and relationship conflicts with loved ones.

Read on to learn more about the 17 most common symptoms. 

Agitation

Agitation is a feeling of anxiety or nervous excitement. Like many symptoms experienced after trauma, agitation is understood on a spectrum. Words like restless, uneasy, and tense generally describe mild agitation. When we’re agitated, we may be fidgety or find it hard to sit still. Agitation can build to the point that we’ve become short-tempered or continually irritable. Untreated trauma can contribute to aggressive or harmful behavior toward ourselves or others.

Nervousness and anxiety

It’s normal to worry about stressful situations (like a job interview or putting an offer in on a house) before they happen. But when we experience symptoms following trauma exposure, these nervous feelings are persistent and all-consuming to the point that they disrupt everyday life. Tense, worried thoughts often manifest physically. For example, when we’re exposed to trauma and experience anxiety, we might have an increased heart rate, breathe rapidly, sweat, or feel tired. 

Problems with concentration or thinking

The body’s fight-or-flight response turns on when we experience trauma or a very stressful event. And sometimes it stays on long after the traumatic event, which can make us feel like we need to be on constant high alert. This, in turn, makes it challenging to concentrate or think clearly. 

Problems with memory

After experiencing trauma, the fight-or-flight response may become “stuck” in an over-activated state that causes nerve growth around the amygdala (also known as the brain’s “fear center”).3 The amygdala – along with the hippocampus and prefrontal cortex – plays a role in the brain’s ability to process stress and memory. Memory loss can also occur as a defense mechanism. 

Headaches

When the fight-or-flight response is triggered, the body releases cortisol and adrenaline – two hormones that help it respond to a threat. When we experience symptoms of trauma, our fight-or-flight response can become locked into a continually activated state, and, in this state, our bodies produce hormones which can impact the body’s nervous system, sometimes resulting in headaches4

Depression and crying spells

Depression negatively impacts how we think and feel about ourselves. It can also influence the way we behave. When we are exposed to trauma and experience depression, we may feel sad, lose interest in activities we enjoyed before their trauma, feel guilty and worthless or notice changes in our appetite. Depression can also cause increased fatigue and disrupted sleep – we might have trouble sleeping while others sleep too much. And at its worst, depression can lead to suicidal ideation.

Suicidal thoughts or attempts

We can be so overwhelmed by our symptoms that we sometimes consider harming ourselves or suicide. When we’re experiencing trauma symptoms, we can also experience depression, panic attacks, anxiety, and substance abuse and are at higher risk for suicide. In fact, people diagnosed with trauma symptoms are 9.8 times more likely to die by suicide.5 

If you are thinking about suicide or need emotional support, please text “HOME” to 741741 for free, 24/7 crisis counseling from Crisis Text Line. We want you to know that you are not alone and that there is hope. 

Mood swings

Trauma triggers and other common experiences like panic attacks and bursts of irritability can cause sudden mood changes following trauma exposure. While bipolar disorder is a different condition, the mood swings that come with trauma exposure may sometimes be mistaken for bi-polar disorder, and in some cases, we may have both conditions. Working with a licensed clinician is the key to figuring out the right diagnosis.

Obsessive-compulsive tendencies

While being diagnosed with trauma symptoms and Obsessive-Compulsive Disorder (OCD) are different conditions, after we’re exposed to trauma, we may behave in ways that look similar to OCD. For example, we may check the locks on their doors several times before leaving the house in response to the hypervigilance that can come after a trauma. 

OCD and those diagnosed with trauma symptoms can both suffer from intrusive, disturbing thoughts. When we experience both conditions, we often feel a constant impending sense of doom or dread. 

Panic episodes

Feeling afraid is common when we’re exposed to trauma. When we are suddenly overwhelmed with intense fear, it could mean that we are experiencing a panic attack. Sometimes these episodes seem to come without warning or reason. Other times, they happen in response to a reminder of our trauma.  

During a panic attack, we may feel like we’re not in control of ourselves or afraid of dying. Chest pain, trembling, hot flashes or chills, a choking sensation, and other physical symptoms are commonly associated with panic attacks.

Paranoia

In reaction to traumatic or highly stressful events, we can become paranoid. Our belief that we are unsafe causes us to act highly guarded and suspicious of others. We adopt this way of thinking to protect ourselves from being harmed or harassed. 

Shakiness

Shakiness is related to many common trauma symptoms like agitation, nervousness, anxiety, panic episodes, and substance abuse. 

Substance abuse 

When experiencing symptoms following trauma, we may use drugs and alcohol to cope as taking substances can temporarily reduce or numb the upsetting feelings we’re experiencing. 

Are There Other PTSD Symptoms?

Yes. Experiencing symptoms of trauma can also commonly include flashbacks, hypervigilance, nightmares, and sleep disturbances. 

Trauma affects us all differently.

Treating Symptoms of PTSD with Stella

In recent years, the Stellate Ganglion Block (SGB) has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that indicates that the SGB is an effective treatment for trauma symptoms regardless of gender, trauma type, PTSD-related medication use, history of suicide attempt, or age.6 

SGB by Stella has the potential to help millions of people with emotional trauma experience lasting relief. To learn more, please visit our “How It Works” page.

  1. Ellen C. Meltzer, MD MSc,1 Tali Averbuch, MPP,1 Jeffrey H. Samet, MD MA MPH,1,5 Richard Saitz, MD MPH,1,3,4 Khelda Jabbar, MD,6 Christine Lloyd-Travaglini, MPH,7 and Jane M. Liebschutz, MD MPH1,5 Discrepancy in diagnosis and treatment of post-traumatic stress Itkowitz, C. (2021, October 28). Dropping the ‘D’ in PTSD is becoming the norm in Washington. The Washington Post. Retrieved February 2, 2022, from https://www.washingtonpost.com/news/powerpost/wp/2015/06/30/dropping-the-d-in-ptsd-is-becoming-the-norm/
  2. disorder (PTSD): Treatment for the wrong reason https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310322/
  3. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD) https://www.sciencedirect.com/science/article/abs/pii/S0306987709000413
  4. B. Lee Peterlin DO,Gretchen E. Tietjen MD,Jan L. Brandes MD,Susan M. Rubin MD,Ellen Drexler MD,Jeffrey R. Lidicker MSc,Sarah Meng DO Posttraumatic Stress Disorder in Migraine https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2009.01368.x
  5. National Center for PTSD. PTSD and Death from Suicide. Retrieved 9/28/21 from https://www.ptsd.va.gov/publications/rq_docs/V28N4.pdf 
  6. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: https://www.painphysicianjournal.com/current/pdf?article=NzM5Nw%3D%3D
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How the Stellate Ganglion Block (SGB) Can Augment Treatment Plans

How the Stellate Ganglion Block (SGB) Can Augment Treatment Plans
By stella
13th Feb 2022

The following article refers to PTSD (Post-Traumatic Stress Disorder), whereas at Stella, we use the term PTSI (Post-Traumatic Stress Injury). We encourage you to adopt this language to break the stigma against Post-Traumatic Stress.  Read more about the shift from PTSD to PSTI here.

While sixty percent of men and fifty percent of women experience trauma at least once in their lives the impact of trauma can vary greatly from person to person.1 That means that each healing journey is unique.

When we seek relief from symptoms following trauma, many options come up: pharmaceutical drugs, exposure therapy, EMDR, insight-oriented therapy, RTM, yoga, mindfulness-based stress reduction… The list goes on.

For many, the formula for lasting relief combines biological and psychological interventions. Think ketamine infusion therapy plus group therapy or EMDR therapy plus daily meditation. 

The idea of researching all available treatments can be daunting. And deciding where to start our healing journey – or what to add to it – takes time and serious consideration. That’s where Stella comes in. 

In this article, we explain what the Stellate Ganglion Block by Stella is and how it can treat symptoms of PTSD (which Stella refers to as PTSI). We’ll also describe how we create a custom plan for each person we work with – because we don’t believe in a one-size-fits-all approach.

What Is The Stellate Ganglion Block?  

When we experience trauma, our body’s fight-or-flight response turns on, and sometimes it stays on long after the traumatic event. Brain imagery data suggests that trauma symptoms cause changes that are visible in the brain.1 Dr. Eugene Lipov, Stella’s Chief Medical Officer not only published the first case report exploring the use of SGB to proactively address trauma symptoms, but also published the first unified theory of how SGB works.

Dr. Lipov suggests that the local anesthetic temporarily “turns off” the Stellate Ganglion, which has been sending signals via nerve pathways to the amygdala, causing nerve growth.2 

The Stellate Ganglion Block (SGB) is an injection of local anesthetic into the stellate ganglion – a bundle of nerves in the neck – that helps restore normal biological function and can efficiently relieve even the most severe trauma symptoms. This can stop the nerve growth that is occurring and eliminate or prune the extra nerve fibers that have been created, thereby resetting the amygdala to its pre-trauma state.2 

Stella continually refers to emerging research and practice standards and is committed to using the most innovative methods available across our nationwide network of care. Instead of using the standard SGB protocol, which was developed for pain, we provide a “Dual Sympathetic Reset” to give those we work with the best chance of achieving a positive outcome.

The Benefits of SGB by Stella

We do not require trauma histories.

Before procedures, our Patient Care Team needs to know what symptoms are being experienced. They collect this information with a short, online test called the PTSD Checklist (PCL). Next, the score is reviewed, and additional background information is collected. We’ll then discuss symptoms in further detail to help determine whether SGB is the right treatment path.

Most are surprised to learn that SGB is an effective treatment option regardless of gender, trauma type, age, PTSD-related medication use, or history of suicide attempts.4 

SGB can accelerate the positive impact of existing treatments.    

Feeling like we’ve hit a plateau or are too overwhelmed by trauma symptoms to attend therapy is common – and SGB may be able to help. After SGB, a sense of calm may be felt, which allows for a new type of participation in therapy that may have felt impossible before.

SGB can be done at any point on a healing journey. 

Whether trauma was experienced months or decades ago, SGB may be a good treatment option.

SGB takes less than 20 minutes. 

The injection itself takes less than 20 minutes. On the day of the procedure, expect to spend several hours at the Treatment Center to allow time to check-in, Twilight Sedation (if desired), the SGB, and follow-up observation.

SGB is safe.

Who performs the Stellate Ganglion Block? Every Stella doctor is Board-Certified and personally trained by Stella’s Chief Medical Officer, Dr. Lipov, in our proprietary SGB methodology. We also require our doctors to use image guidance for correct needle placement. 

Interested in learning what medication is used in a Stellate Ganglion Block? The local anesthetics Stella uses are Bupivacaine or Ropivacaine; both of which are FDA-approved.

Serious side effects are extremely rare.

Stella’s Clinical Approach

Stella takes a trauma-informed approach to treatment and communication. We recognize that we all experiences and processes trauma differently. Our Patient Care Team will meet you exactly where you are. We’ll provide all information needed to confidently make decisions about treatment. 

We respect the relationships had with mental health care providers, doctors, or other healers because they share the same goal as Stella: to help those experiencing symptoms find lasting relief. We’re committed to building a world where no one needlessly suffers from the symptoms of trauma. Pairing our breakthrough Stellate Ganglion Block procedure with treatments from other skilled providers gets us one step closer. 

PTSD Medications & SGB

Before scheduling the Stellate Ganglion Block (SGB) treatment, a dedicated Patient Care Coordinator will review any medications actively being taken. Most prescription medications that treat symptoms of trauma do not interact with either of the local anesthetics – Bupivacaine or Ropivacaine – that Stella doctors use for SGB. 

After SGB, working with prescribing providers is recommended. They may decrease some medications or suggest taper off them altogether because the trauma symptoms are not as severe as before SGB. Others wish to stay on their medications. In all cases, we strongly encourage those who receive SGB to continue working with their prescribing providers to make the best decisions for their wellbeing.

Like many other medical procedures and surgeries, Stella requires that blood thinners are stopped in the days before the SGB procedure as they can cause problems. 

SGB & Other Therapies

The Stellate Ganglion Block (SGB) is just one part of the healing journey. For when we feel out of control in our bodies or alone in a room full of people, SGB has the potential to restore a sense of calm and clarity we crave. And when paired with skilled therapy, SGB can be life-changing. Again, the best outcomes are often the result of combining biological and psychological interventions. 

Mental healthcare providers can help maximize and maintain SGB’s positive impacts. For example, when we aren’t distracted by our symptoms, it becomes easier to be fully present during therapy sessions and thus integrates takeaways into everyday life. 

We think that those who received SGB by Stella put it best:

“I’m not as fearful or panicked as I was, but I’m still working through my anxiety with my therapist. She has hope for me and feels like I have made a good leap in my process.” 

“I feel like [SGB] has been a HUGE turning point in my healing. It’s allowed me to start a spiritual 12-step program that requires intense vulnerability in a group setting. I can feel appropriate emotions but not get triggered by others’ trauma. This is a first.” 

If you’re a mental healthcare provider looking to join Stella’s mission to end the needless suffering caused by emotional trauma, please find more information about how to collaborate with Stella here

How to Learn More

Tune in to our monthly webinar Treating Trauma: The Stella Approach hosted by Stella co-founder and leading trauma expert Dr. Shauna Springer and Stella Patient Ambassador Paul Whitmer. This webinar deep dives into how the Stellate Ganglion Block (SGB) addresses symptoms of emotional trauma.

You can also find more information on our website’s “How SGB Works” page. And if you’re looking for SGB treatments for PTSD (which Stella refers to as PTSI), explore Stella locations here.

  1. Alkire, M.T., Hollifield, M., Khoshsar, R., Nguyen, L., Alley, S. R., and Reist, C. (2015). Neuroimaging suggests that stellate ganglion block improves post-traumatic stress disorder (PTSD) through an amygdala mediated mechanism. Presented at the Anesthesiology Annual Meeting, October 24, 2015.
  2. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD) https://www.sciencedirect.com/science/article/abs/pii/S0306987709000413
  3. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from https://www.ptsd.va.gov/understand/common/common_adults.asp 
  4. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: https://www.painphysicianjournal.com/current/pdf?article=NzM5Nw%3D%3D 
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