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It was at the state men's hockey tournament in March and Patrick Bailey and Natalie Johnson, who share the same profession – they are nurse anesthetists – and maintain social relationships.
Bailey described it as follows:
"Natalie said," Hey, I need to talk to you about something. "
"I said, what is it?
She said, "Do you know anything about ketamine? "
"I said," Yes, I want it. "
"She said," We need to open a clinic. "
"I said," Yes, let's do it. ""
Thus, six months later, a central entrance clinic called Ketamine North and today – if the schedule permits – the first infusions of the drug for the treatment of mental health in Duluth for over a year.
Ketamine has long been an essential tool in anesthesiology and with a history better known as a partisan drug. It has emerged more recently as a treatment for the type of mental health disorder that does not respond to conventional treatments. It's pretty new in the war on mental illness so that long-term studies are simply not available. The American Psychiatric Association, in a "consensus statement" published in April 2017, warned that "although ketamine may be available for some patients with mood disorders, it is important to take into account the limitations of the available data and the potential risk associated with the drug. " during the examination of the treatment option. "
But the available studies show a success rate of up to 85%, says Johnson, and also show a much faster improvement rate than traditional antidepressants.
Certainly, there are patients who swear by it. When the Essentia Health-Duluth Clinic ended ketamine treatment after the retirement of Dr. Michael Messer, a psychiatrist, in July 2018, a couple of patients described the treatment they received transforming their lives and expressed their concern for himself and other patients not benefiting from any such service. available at Duluth.
At that time, the closest remaining places for therapy were in Ely and the Twin Cities. In addition to distance alone, there are some other complications for people traveling to get treatment: initial infusions are usually given six times over a two-week period; and the patient has to go home.
Johnson, who practices at St. Luke's Pavilion Ambulatory Surgery Center; and Bailey, from the Community Memorial Hospital in Cloquet; independently concluded that Duluth had a void to fill.
"We knew there was a need, and there is already a shortage of everything related to mental health," Johnson said.
The chance meeting at the hockey tournament was followed by a more formal meeting in early May. They attended training sessions, found a name – Ketamine North – and a logo, ordered scrubs, equipment and supplies. They looked for an office that met their needs and found it at 1003 E. Central Entrance. It is a shared space with Zenith Spine & Wellness on the ground floor of the building occupied by Planned Parenthood.
There is no patient without an appointment. The patient must be referred by a mental health professional and must have been prescribed standard medications with little effect. Johnson and Bailey are clear that they are not mental health professionals, but will work with the patient's prescriber to offer a specific component of their treatment.
However, they are health professionals whose experience includes ketamine. Although side effects are rare, they are prepared with the help of an "emergency cart" in case of a medical emergency. Ketamine does not treat a small number of patients, such as those whose heart health can not tolerate a slight increase in blood pressure. But the risk is so low, said Johnson, that some clinics they know have never had to send anyone away.
In fact, one of the attractive aspects of ketamine treatment is a low risk.
"You hold your breath," said Johnson. "It's not like a narcotic or fentanyl where you stop breathing. This is a very low risk. "
But it is also an off-label treatment. Although the Food and Drug Administration has recently approved a variant of ketamine in a nasal spray for certain uses, the infusions that will take place at Ketamine North are not yet approved. This means that they are not covered by insurance and that the patient will have to bear the cost of $ 399 per infusion.
That could add up. After the initial six infusions, the patient will need maintenance doses. The need varies depending on the patient, but it could usually be once a month for a year to a year and a half, said Bailey.
Although Bailey and Johnson expect most patients to benefit, if a patient has not seen improvement after six sessions, it will not help to continue, they said.
Even the patient who benefits will not be cured. Johnson and Bailey have described this as helping someone who is virtually unable to function to reach the next level.
"It's not like the guy was going to jump on the street, happy, but that would bring him back to a working state," Bailey said.
Then the patient can return to his therapist and continue to work on things that will improve his quality of life, Johnson said.
The infusion itself will take place in a private or semi-private room that Johnson describes as "spa-like". The patient will sit in a reclining leather chair with a weighted blanket, Tranquil Sound machines and, in both private rooms, access. to aromatherapy. They can treat up to four patients at a time, and both will be present each time only one patient is treated.
The infusion itself lasts 40 minutes, but patients are told that their total time at the clinic could last up to two hours. The dosage is far from the same as that used in the "Special K" party medication or in anesthesia.
"At these doses, people just float for 40 minutes," Bailey said. "They will be responsive. They will be able to answer questions. "
The immediate effects will disappear about 15 minutes after the infusion, Johnson said, although patients are forbidden to drive for 24 hours.
The sessions will be by appointment and will take place at night and at weekends, as Johnson and Bailey already have full-time jobs. In addition to these jobs, everyone has a family – two children each. "We have supportive spouses," Johnson said.
They have a website and a sign facing the central entrance. A letter will be sent to mental health and behavioral professionals this week. The mental health professionals with whom they spoke welcomed the return of ketamine for the treatment of mental health in Duluth, they said. But they are aware that this might not be a unanimous opinion.
"I'm sure some people are not going to refer their patients," Johnson said. "I hope that if the patient wishes, he will support him and we would like to work with him."
Visit the Ketamine North website at ketaminenorth.com.
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