Frequently Asked Questions
Why an anesthesiologist or nurse anesthetist?
Anesthesiologists are physicians, and CRNAs are registered nurses with advanced training in anesthesia. Both are specially trained in administering anesthetics and pain medications, and taking care of patients during these processes. They are experts in monitoring patient responses, and treating complications when they arise. Ketamine and lidocaine are two such anesthetics.
Anesthesiologists and CRNAs are also experts in starting IV's, and administering IV fluids and electrolytes.
This training uniquely qualifies anesthesia providers to safely administer these medications and fluids.
What will happen during my infusion visit?
When you arrive, we will have you go to the bathroom prior to sitting in our very comfortable recliner. For the first 5-10 minutes, we will have you complete any outstanding paperwork, and we will perform a brief, focused history and physical exam. After this, we will place a small IV in your arm or hand. This usually only takes a couple minutes. We will place a blood pressure cuff on one arm, which will take your blood pressure at least every 10 minutes. Another monitor will clip into your finger to measure your blood oxygen. We will also put some stickers on your shoulders and side to watch your heart with an EKG. Once this is done, you can get comfortable, recline the chair, put on headphones, cuddle in a blanket, or whatever you desire. We will begin the infusion. The infusion is controlled by a small syringe pump that gives the ketamine, or lidocaine, over a given time period. We can turn the lights down, and filter in some essential oils, if you prefer. All you have to do is relax. We will stay close by the entire time, monitoring your vital signs. Occasionally, we will ask you how you are doing to make sure you aren't too sedated, and that you aren't having any major reactions. Most people don't feel anything for the first 5-10 minutes.
Often, with ketamine, people will start feeling progressively drowsy. Many people will start to feel "out of body" or like a "floaty" sensation. This can be a bit scary for some people, but just know that this is a desired state for the medication to work, and it is only temporary, as it subsides within a few minutes of us stopping the infusion if it becomes too uncomfortable or intense. Some people may experience an increase in anxiety and restlessness. This, too, subsides quickly if we stop, or slow, the infusion. Nausea is a possible side effect, and can be treated by other medications. It is extremely rare for someone to pass out, become fully unresponsive, or stop breathing. Again, stopping the infusion would resolve this, and we are specially trained, as anesthesia providers, to manage these issues. The typical ketamine infusion for mental health issues is 40-60 minutes, and 4 hours for chronic pain conditions.
With lidocaine, people will also feel progressively drowsy, and may experience body heaviness, and mind slowness. Your speech is likely to slow. You will probably feel "numb". You may experience ringing in your ears, a metallic taste in your mouth, and/or numb lips. Again, we will be constantly monitoring you, and asking how you are doing. These symptoms resolve within minutes of stopping the infusion. The typical infusion lasts 30-45 minutes.
Once the infusion finishes, we will continue to monitor you until you are fully awake and able to stand and walk. This usually takes 15-45 minutes, depending on the length of the infusion. Once you are at your baseline level of consciousness, any side effects have subsided, and your vital signs are at baseline, we will take out your IV. We can also take this time to answer any additional questions and set your next appointment.
What are our Covid-19 precautions?
We are committed to the highest safety measures to keep you safe.
All staff are fully vaccinated.
We require you to bring your own face covering, if you are not fully vaccinated. We only take one patient at a time.
We clean all patient areas between appointments.
We provide hand sanitizer.
What should I bring with me to make my infusion session more comfortable?
Due to cleanliness issues, we are unable to provide items that would be re-used by multiple patients. We do encourage you to bring any personal items that will make your experience more comfortable, such as a blanket, favorite stuffed animal, meditation idols/stones, headset for music, pillows, sleeping mask, etc. We highly recommend having a support person remain with you during the entire infusion. We have a bluetooth speaker, essential oil infuser, and Himalayan salt rock lamp available.
Why do I need a referral for chronic pain and mental health infusions?
We are a consultation service. We do not primarily manage patient's chronic pain and mental health issues. Therefore, we require that you have a healthcare provider who is primarily in charge of managing these issues. That will most often be the provider prescribing your pain medications and treatments, or your mental health medications and treatments. We require that this provider be on board with your infusion therapy, and we will consult and update this provider about your treatments as needed.
Why do I have to have someone drive me home, and be with me for 24 hours?
Ketamine and lidocaine are both anesthetics. They both alter your level of consciousness, and cause extreme drowsiness. Effects can last many hours after an infusion, even if you "feel fine". Although highly unlikely, serious effects can still happen hours after an infusion. For these reasons, we require you to have someone drive you home, and be available to help you for about 24 hours after the infusion. You will not be able to have an infusion if these criteria are not met.