From Delivering Babies to Healing Trauma: Dr. Karen DeCocker's Mental Health Revolution

Welcome back to another episode here on the heart and hustle podcast with Dr. Karen that said when I spoke to her, I used to deliver babies and now I help deliver themselves from trauma. The body always remembers but can also heal. What a strong just statement. Um, so you're no longer delivering babies. Is that correct? That's correct. Haven't delivered a baby since 2019. Wow. Do you miss it at any um moments, but I really have evolved from that position and not like evolved in a better way or something like that, but it's just, you know, evolution of my life work and kind of where I've gone from there. Um, so I miss moments of it, but I don't miss, you know, being up all night with, you know, missing my own family events and weekends and holidays and stuff because that's a job that does not have any hours and babies come when they want to come and so, you know, we all take turns on 24-hour shifts and, you know, somebody's got That's a question, Dr. Karen. I really want to know that because I've had two kids of my own, obviously, not me, my wife. you know how I was there and I remember one of our kids being born like 2 something in the morning and it's like we got to call the doctor and it's like the doctor just rolled out of bed or something. Are you guys sleeping at the hospitals? Yeah, we can sleep at the hospitals um if we have um other patients there and depending on like how big your practice is or if you don't live within a certain amount of time. So like if you're more than 15 minutes away from the hospital, you have to be there during your call time. Um, but if I have multiple patients and I have a 24-hour shift, like, yeah, I sleep. There's little call rooms there, little teeny bunk rooms that have, you know, just little single twin beds in them and it's a way to lay down and you take an hour where where you can if you need to because it's I don't think people realize that. I didn't notice that. And then when my doctor comes in at 217 in the morning and I can see she's just kind of rubbing her eyes and everybody's doing the work and she's just sitting there. I'll tell you though, I'll tell you the story real quick. we get into what you're doing today. But, um, I'm watching her. She looks very tired, you know, but she was so on point. And my wife was like, she said, "First put a mirror here, then she put the mirror, then she starts to throw up." And I guess once she's throwing up, the baby pushed out in seconds. And the doctor was immediately on it. Like, no one noticed that the baby was out, but the doctor was on it. And I'm like, shout out to the doctor that just rolled out of probably the bed with a 30 minute nap, baby. Because it was during a pandemic. So just imagine they were inducing people at this point to try to get beds available. So it was pretty crazy time. So I can imagine she but she was so kind, just so good at what she did. Um and respected her for that because you guys really it's a good provider that you really don't notice them in the room so they're not being intrusive and things. Um so that's actually a hallmark of a good provider because you know you don't want to be adding to the chaos. You don't want to be adding to the hustle in the room, but you're there purely observing, doing what you need to do and focused on what you need to do. And that was a perfect example of that, right? Like everybody else is like doing little things and stuff and forgetting that the patient's right there having her baby in the meantime, right? And yeah, you know, but I miss those little things. Yes. But yeah. Yeah. I can imagine, you know, seeing the smiles on people's faces. I mean, and there's also some, as you mentioned, there's trauma that goes on, not even from just that moment that they're in the hospital being delivered, but then life happens. There's trauma through a child's life. And I think I kind of spoke a little bit on mine on what I've encountered, the sexual abuse, the adoption. And Dr. care and the more that I do this and the more that I share my testimony realizing that there's so much trauma going on at different levels. Why why did you get into this space after going to deliver babies where you get happy moments and then now you're in the space where you have to listen to some of these stories that you have to take home and and sometimes it's very um heavy. Yeah. Well, it's interesting. Trauma is everywhere, right? And so when people would say to me, "Oh, you get to deliver babies. It must be such a nice job and stuff." That's a very teeny teeny window of what we do, right? That's a teeny teeny teeny part of what we do. We take care of women throughout their lifespan, pregnant, not pregnant, you know, through their pregnancies, you know, after they have the babies. And unfortunately, not all births are happy and easy and good. And there's a lot of, you know, issues leading up to the pregnancy. There's a lot of stuff kind of this answers a little bit of both questions in that there's a lot of family stuff that comes up. There's a lot of um you know women facing their own traumas. Um maybe you know sexual traumas related but it could be family dynamics. You know this is they've never had any attention paid to them but now they're having a baby. suddenly they're in the spotlight and you know so it just there's so much family stuff that comes out and then there's family politics who's going to be with the mom who's not and we don't like the father we this we that like so much drama and tension sometimes um and you know not all births are positive outcomes you know thankfully it's a really small amount um but not all pregnancies are happy um there's an increase in domestic violence um during um pregnancies disase like almost threefold. Um, so there's a lot of stuff that goes on and people don't stop being people just because they're pregnant, right? So there's mental health, mental illness, addiction, and things that are all happening in a woman's life before pregnancy are still there during her pregnancy, and we have to help manage that during that time. And I think when you and I first talked, you asked me about that and the population I was taking care of, there was a lot of substance abuse. It was in a very poor, you know, economically challenged um environment and there was a lot of drug use, a lot of mental health, very little resources. So, we had to be the people to take care of the women who were pregnant because there was no mental health care providers. And so, you know, we were the ones that had to do that piece of it, too. So, mental health is part of any bit of nursing, right? And um you know, and any part of life, you just mentioned it, the people you've talked to, you're noticing it. I think what's surprising is when there's not, you know, kind of dramatic stories in the background. That's it's it's absolutely the minority of people have had very idealic, very unchallenged lives to make it all the way to adulthood and not have, you know, some level of stuff happening. And it could be for a brief period of time. It could be kind of this small stuff, you know, ongoing. It could be just a a life of poverty, a life of, you know, um, racial tension, whatever it may be. It doesn't have to be somebody's being beaten or abused or something. The the challenges, and we talk about that like in different other socioeconomic pieces, you know, little access to good health care, little access to good education are all traumatic. It's just in different pieces and different levels and scales, right? there's not really a comparison. Um, and you know, but it's part of everyday life, right? Love it. No. Yeah, you're right. There's there's a little bit of everything. And um, everybody's life is just very different. And I tell you how this is just having a conversation with a neighbor. Um, I always love to talk about life and where people are at. And it was the holidays. I come over with a a drink, alcoholic drink to my neighbor's house. And one neighbor, my neighbor that lives there, he always says like, "No, I'm good." Older guy, um, almost 50. And then then he he had a friend older guy almost 50. Oh my god. The kid stop it. I miss it until he's 49. I said you're 50. He's like I'm 49. I'm like I mean ground it up. You're 50 years old. He hates it. But um no I his friend 35 years old and I went over a drink. He's like I don't drink. I'm like like you don't drink at all? He's like I'm 10 years sober. He's 35 years old. I'm like what? Like by choice? Like what happened? And so he started telling me a story. So we were just talking about our 21st birthday. He's like, I spent my 21st birthday in rehab. The other person spent their 21st birthday in the military. I spent 25 birthday my 21st birthday living my life. But you can see how everybody's is very different. Everyone's life is very different. The question I asked them, Karen, was um I didn't have, you know, I was adopted. I life was lifeing for me. But they I knew they had both parents. So I said, "With you guys having both parents, what made you what made you get into like drugs? Why why do you think that was it?" Because it wasn't just alcohol. It's when he started drinking. When he started drinking is when the drugs started to also take play and the drugs were taking over his life, you know? Um and he didn't get sober till he was 25. And um he's like, you know, I had too much freedom. My mom had to work two, three jobs and I was just in the wrong crowds, right? So sometimes we think someone looks great cuz they have mom and dad and they look sharp at school or whatever the case is, but they go home and you kind of mentioned it, people don't don't they don't get attention until that moment of being a parent and all of a sudden there's attention there and they don't even know how to deal with that and there there's all these things that's kind of probably been swept under the rug. Do you feel that that's what kind of led you as you're hearing and seeing these things in the hospital rooms um led you to the to go and make the transition? Um that's an interesting question. Um I don't know that there was any one pivotal thing, right? Um all of nursing, all of health care is really dealing, it's not just somebody's disease of the moment, right? It's not somebody's cancer. It's like what are their household resources? Are they going to have somebody to be able to drive them back and forth to treatments? Can you know like are they able to leave their work? Right? There's so much socioeconomic life stuff and it's not even a that's not even like a poverty thing, right? Like so I talked about one time that I couldn't take the time to do one of the treatments that we offer. I could, but it would be really difficult, right? Like with my work schedule, it's a daily thing that you have to do for 36 days. And you know, it's like so even though it's a short interruption, how do you interrupt your day like that to go to a place for treatment and come back? and we underestimate how much of a commitment life, you know, like all these treatments and things are. So to kind of bring that back together is that we're always navigating that as healthc care providers, right? And I can write you a prescription, but if you don't you can't pick it up, then you know it's no good, right? And I would go to write a prescription. I was like, are you going to be able to pick this up? Are you willing to take it? Like I had to like over time I learned to ask my patients is it worth even writing this because if it if they're not going to do it either because they don't want to or they can't financially they don't like then I have to come up with another creative way to properly solve that problem if possible right versus thinking I'm just going to write this prescription they're going to get it they're going to take it and things are all going to be good. And so we're always juggling that and we're always having to think through those pieces and that's part of people's mental health too, right? And I think that you touched on this on a prior podcast is that mental health is part of our body, right? Like so how how is our brain and our nervous system working together to help us optimally live and live symptom free, right? And so we can't ignore any body part. We can't say, "Oh, well, I'm only worried about pregnancy. I'm not going to worry about the person's heart. I'm only worried about the pregnancy. I don't care how her lungs are performing." Nope. I need a heart that's working well and lungs that are working well to, you know, so everything is essential. And so looking at things from that perspective, um, healthc care is always dealing with all of general body care. And so the brain is arguably probably the most and the nervous system are probably the most important, right? If you have brain death, nothing else works, right? You can live with fake artificial this and that and you replace different parts, but you can't replace a brain. You can't replace a nervous system. And so those have to be optimally working. And I just kept seeing that more and more and more and more. And those are the things that weren't paid attention to. Um, and you know, I think I'm really deviating from the question that you asked me. Good question. Actually, I'm I'm kind of add on to that. You keep talking about um, just providers, right? And earlier you mentioned a good provider, and obviously in anything, there's going to be the good, there's going to be the middle, there's going to be just flatout bad. What do you wish more providers actually understood about trauma and behavior? Because you mentioned it is so important to understand that because it's just more than just a pregnancy, right? Oh gosh. um trauma and behavior is that when people have like chest pain, right? They we can be sympathetic. You're like, "Oh, you can see them, you know, having this agony and you're like, oh, what's wrong?" You want to comfort them and you want to help take care of them. But we have a really weird reaction when somebody starts acting behaviorally different, like really anxious or angry or, you know, it's really challenging. It's really hard for us to look at that emotional or those behavioral things that we see that come along with when the brain or the nervous system isn't functioning optimally. You know, if somebody's anxious or somebody's, you know, distressed and acting out and things, it's much more difficult for us to separate our emotions. We can say, "Oh, I'm sorry your heart hurts." Or, "I'm sorry that your leg, you know, was broken and you're having this pain." pain and we have this empathy for that. But I wish that people realize that the behaviors and the symptoms that we see somebody who's depressed or anxious is no different than somebody having pain in their arm or their leg or something. It's just telling us that something's wrong. They're not willfully doing these things just like somebody not willfully having pain in their chest. Yeah. And so I think for so long we looked at the behaviors as the problem and that's the issue, but it's not the behaviors aren't the issue. The issue is something's wrong with the brain or the nervous system that's creating that behavior. And instead of trying to think they're behaving poorly, what's what's causing that? Somebody isn't behaving poorly because their heart hurts, right? It's just a different set of symptoms that are showing up. And um I think it's because it changes personality or it's more difficult to deal with. We feel uncomfortable. But if you can separate the behavior or the expression of these symptoms and realize that's coming from the same place of some part of the body isn't functioning right. Um otherwise that wouldn't be going on for them. Right. And so that's what I really wish people understood. Hey, real quick. Have you enjoyed the podcast? We first want to say thank you and we also just want to give you a little insight of what we're up to at Francis. Some even realize that we're working with organizations to help them use AI to create that real human communication experiences where that's actually supporting your your families, those patients or the entire community. We're actually creating tech that connects. Check it out. Francis.ai. Dr. Karen, you mentioned um earlier just like medication, someone not being able to take it because of financial reasons or whatever the reasons may have really been that they don't want to take them. Is there holistic ways that people without medication? I think like myself, I'll be quite frank, I hate taking pills, so uh whether it's a vitamin, you know, like now I take vitamins because I'm a little older. I'm 35, Dr. Karen. Okay, a little older. Uh but I hate taking these vitamins. A matter of fact, do I got some on my desk? They're just so big. But is there anything that people can actually do when in instead of taking medication um are you guys in that space of finding other ways? Absolutely. So, but I also want to be very clear that medications do serve a really good purpose and a really good function too, right? And so again going back to the body like we don't say gosh I if somebody has high blood pressure you know yes you can diet you can exercise you can lose weight you can stop smoking you can do all these other things right but at some point those things may not work for everybody or their body may have gotten to a point where you know those changes aren't enough. Maybe they have a genetic you know um indication that their blood pressure is higher. It's a, you know, something that they're completely not in control of. So, we need a medication to help control those blood pressure symptoms. So, again, it's no different for a medication that helps somebody's anxiety, depression, or even more importantly in in disorders like schizophrenia and things like that. There's no diet fix. There's no anything along that line. So mental health medications are no different than somebody taking something for their diabetes or for their, you know, high blood pressure, it's really zero difference. And so if you're going to stigmatize somebody taking a medication for the mental health symptoms that help them sleep, that help them be more functional, that help them keep, you know, the, you know, like their emotions regulated, those pieces. How is that any different than somebody who's taking something to keep their blood sugar in check because their pancreas isn't working right? And so sometimes there are things that we can do, diet and stuff. Those things are extremely important and talk therapy is extremely important, but there are underlying things that right now we can't change without the use of medications. And so it's not just taking a pill. It's not a fault. It's not a it's not a escape. It's not like a cheat or something um any more than taking, you know, an antibiotic for an infection is really. And so I really really hope that people don't could get past the idea that taking a medication for that. If you don't have enough vitamin D in your body and you take some vitamin D, is that a weakness? No. That's a strength because you're doing you're providing your body what it needs to be optimally healthy, right? And so the people who take medications, you know, that's the same thing. But yes, there are things that we can do that aren't medicationbased. And a lot of people think that you have to be extremely ill for some of our treatments like ketamine or TMS. Um, and we can get into that if you want to talk about the different modalities, but yeah, there's a whole spectrum, but meds are not the enemy. It's just unfortunately in psychiatry many people don't know that there's lots of other options that aren't meds only or they use meds and they try meds and try meds and try meds for way too long or put people on way too much or way too many at the same time. It's about using them wisely and when needed. But there's no fault or no problem with that when people do need them. Love it. Which is why you guys are on this national movement. You guys organization that you're with is Stella. Um, and you mentioned we're not here to replace medication. We're just here to give people more options and more hope kind of what we're just talking about now. So when we in that space, what's the origin story behind Stella for those that may not know? What made you join the mission? I mean, not such a career change. You're in the healthcare space, but there was obviously a reason why you decided this is a great organization to to be a part of, right? So I joined Stella really early. Um, the company actually originated in the year 2000. um or sorry 2000 jeez 2020 and um I was thinking I was like wait a minute I think it was like grow do I know more about your organization here right so in 2020 but it was um funded founded by um our CEO Michael Gersonen and um the origin story is that he was part of you know he was called himself a finance bro was part of venture capitalism and you know like funding organization and really did amazing things in that space. Um but then he had the death of a friend. Um that kind of opened his eyes to kind of some things that he had not been exposed to really. Yeah. And right before that death he had that person that died um had introduced him to Dr. Lipoff which is the founding um medical officer for Stella and was talking about some things that could be done you know in this space for people who are really suffering and in retrospect this guy was really suffering and he just wasn't able to access the services before it was too late for him um and so that really kind of pushed our CEO um into looking at what could he do to enter this space and so he jumped in you know head first and even though it wasn't his area of knowledge or this area of comfort. He said, "I want to do something here. I have the capacity to partner with somebody who has the knowledge, the medical skills and so forth. I have the business skills. Let's see what we can do." Um, and then in 20 three, I actually had some patients that I met through um the a program at Rush called at Rush University Medical Center here in Chicago. I was working in a veterans program um for severe post-traumatic stress injury. We were doing a two-eek intensive program where people come from all over the country, spend two weeks with us at Rush. And some of my worst cases, who I was really felt super stuck with as far as I don't know what else to do or what else to offer this person, had treatment with Dr. Lipov at Stella and I was like, what is that? And here I am at a big university medical center, not some little, you know, out of the way practice where I don't know where I'm not being exposed to things. And I was like, how do I not know more about this? And so then I really started doing research into what it was the stellate ganglen block. How did it work? And I then I started to get mad because I thought, how do how am I a professor in this arena in psychiatry working at a really premier medical institution? and how do I how am I not aware of some of the things that are happening in this space and so that led me to actually wanting to try the treatment for myself because I I couldn't understand it didn't really it was really hard for me to wrap my head around and that's just the kind of person I am and so you know I did it out of curiosity had my own stuff like health things and family things I wasn't in a space where you know my patients were but I thought well worst it's going to do is nothing but I want to have the experience experience. And so that's how I met Dr. Lipov. And then about six months later, Stella really wanted to turn the company around and they reached out to me and said, "We really, really want to expand our programming, our offerings, and really get into the full mental health space versus just doing this one procedure." And so that's where I kind of entered into the company itself. Yeah. Yeah. And Michael, great. I mean, he he acts like he doesn't know much, you know, to him. You you ask him and he's telling you, "I'm new at this, right? But I learned so much from him as well. You can tell he's really dived into this and learned so much from it. I ask you, how does that uh gangelian block actually work for trauma? So um the simple version and the non-scientific explanation that I try and use in my elevator speech is that we have a bundle of um nerves called the stellate ganglen nerve bundle here. We have it both on the right side of our neck and the left side of our neck. And it's basically the control center that primes our body for fight orflight response. Right? So the flee, run away, fight, um protect yourself, right? And so this is kind of the central warehouse for that signaling. Okay? And over our lives, we get exposed to little things, whether um it's a big trauma, little trauma, or just plain old learning. Right? If you throw a ball at a baby, they don't put their hands out to catch it, right? It dons them in the face. You're like, "No, no, put your hands out like catch catch it, right?" Yeah. And they have to learn to do that. But over years, you learn to duck when something comes at you, right? Because those exposures teach you something's flying at you, you need to duck or it's going to hit you, right? And so those are all learned behaviors from our nervous system to keep us safe. the same idea of like a hot stove. Kids put their hands on the hot stove. You do that a few times, you learn, right? And right now, if I told you like even kind of conjure the image of like a burner on a stove that's hot, flames, and I said, "Put your hand there." How does that feel? I said, "Put your hand in there." You have like this little like I don't want to. Right. Yep. Yep. And I promise you, if I was standing there and I said, "Put your hand in there." and I tried to push your hand into it. You would absolutely positively not want to put your hand into it, right? You would fight me. You'd want to pull it away, but there's nothing that's saying you can't do it. You absolutely there's nothing physically stopping you, right? Yeah. But your nervous system is saying don't don't do it. Don't do it. Don't do it. Right. And so it's very much that central nervous system learning from exposures to keep us safe. Right? So those are very practical things. Baby stick your hand out so the ball doesn't hit you. You learn to duck. You learn to move. So those are learn behaviors. Don't touch the hot thing. And it becomes so like offensive to you. Like it gives you cringey even thinking about putting your hand in that fire, right? But you could physically there's nothing stopping you just like you wouldn't have to duck if something was flying at you. So when we learn and have these repetitive exposures to things, we adapt to them because our nervous system is there to keep us safe, keep us protected, and make sure that we're safe, right? Yeah. When you've had a bad exposure, just because you're away from it, your nervous system still remembers that kind of situation is like, "Oh, be careful there. That seems similar, too." And these are all things that we're not really aware of, right? It's this signaling that says, "Oh, there's something moving around in the periphery. make sure that you're careful. It could come at you. Those sort of things. So, all this stuff is happening in our subconscious. When you've had lots and lots and lots of exposures to lots and lots of different things, you get really good at protecting yourself, right? And so, it's the same thing like a soldier doesn't think a firework is a gunshot. They know it's not. And that so this is where people get like, oh, they think they're hearing gunshot. No, they don't. They know that it's fireworks, but their nervous system is hearing that and is reminding them of the time. So, they're on this alert, that sound, even though cognitively they know it's not a problem, their nervous system is like, "Whoop, be careful. Be careful." And just like you felt queasy think about putting your hands on on a burner, it's the exact same thing that goes on in a much larger scale for people who've had exposures to lots of small traumas, one big trauma. Your nervous system is there to protect you. So this is the whole buildup for this, right? So that nervous system is constantly feeding the brain. And when you've had so many exposures, we kind of have this tipping of the scale where we no longer get to think about things first. It actually bypasses the thinking part of the brain so that we can react that much quicker and that much faster. Right? So the stellate block actually just anestizes that nerve bundle. doesn't block it permanently. It doesn't turn it off permanently. It basically rests it and says, "Hey, let's get out of this over excitement, this overfly wheel of sending information non-stop rapid fire without thinking of it and giving your body that chance to reset and to rest a little bit. So that when it comes back online, as the anesthetic wears off and goes back through the brain processing, it goes through the part of the brain that can think, "No, that's not gunfire. That's a a firework, and I don't have to have this trauma response." Because what happens is when we get over excited, it goes straight to the amydala, the the fight orflight part of the brain where we're having these reactions that we can't control. So the stellate block is a twominute procedure that anesthetizes these nerve bundles, the stellate nerve bundles, just like when you're getting dental work, right? So it the anesthesia stays there for a little bit, but it allows that nerve bundle to rest and we call it a reset. So that when it starts to fire again, it fires in the normal pattern where, oh, there's a problem. Let me think about it. Is it real? No. Okay. And so you don't have to have reactions that are so extreme to something that's really small. And so it's a very very very simple procedure and works about 80% of the time. Now you said this is only two-minute procedure. Yep. Wow. Yep. Is this is this what's different between what you guys are doing and other traditional mental health clinics or is this what's like I know I I haven't physically been to a mental health uh clinic nor have I ever heard of what you guys are doing. Is this what sets you guys apart? I think what sets us apart is that we have access to lots of different treatments. This is the only treatment that we do. Right. I said we prescribe medications. We do you know trans um magnetic cranial stimulation. So, we stimulate the brain with a magnet pulse that increases the blood flow covered by insurance. We do the ketamine nasal spray. We're agnostic, but we have access to things that are not as commonly prescribed and used. And we have really strong skill set at looking at who would do best from what treatment. We don't try and treat everybody with just one thing. Got it. Not everybody gets therapy only or medication only or ketamine only or not everybody needs the SGB. We have people that come to us that I say, you know what, I don't know that that's going to really address what's going on for you. And you know, so we have really clear um guidelines. We have tons of data, tons of research and really clearly skilled clinicians that will look at everything that's going on with the patient, what they've tried, what they've done, what are their symptoms, as opposed to saying, "This person has, you know, depression, this person has anxiety." It's never that clear. So, we say, "What are the big symptoms that this person is suffering with?" And use that as a clue as to how we might want to treat them. And so we have access in one place, skilled clinicians that understand all those treatments and use them most effectively for patients as soon as appropriate and don't look at things like oh we only do that in the worst case or you know different things where many providers don't have access to certain treatments and so they get really really stuck in this spot of using only one modality because they don't know how to get somebody something else or like me who was like, "What are you doing? You're doing a shot where?" And you know, and this is not that long ago, right? And Dr. Lipov actually did a lot of his research at Rush. And here I'm at that university and how do I not know about it? Yeah. And so we have access and knowledge to a really wide range, which is what I think makes us different. There's other people doing each of the things that we do, but in really segmented ways. How would you say that you guys are um because you guys are scaling in five years, you mentioned 2020 was the start of it all. You guys are truly scaling throughout the nation. How are you keeping your cost down as well while scaling? So actually it's the scale of economy is really helped and um uniquely we've actually been able to lower the cost of the non- insurance covered treatments by expanding our treatment offerings by doing things like med management therapy TMS the nasal ketamine all covered by health insurance we were able to decrease not quite by 50% but close um our costs on the stellic ganglen block or the IV ketamine we were able to bring those costs down because we're now offering a wider range of modalities that are covered by health insurance. And if you have to have a call center that's answering phone calls, answer that same person can answer for three sites the same as they can answer for one, right? And so scale of economy is is you are able you're doing the same processes and you're you know marketing people if they're marketing for two locations or five you know it's you don't have to like have new duplicate everything for every single location. I don't know if that helps. Okay. No no it does. It makes complete sense. Yeah. Um I love this. I'm learning so much and I know you you were a little nervous that I wasn't going to learn from you the same way that I learned from Michael, but I'm I'm learning a lot here because it is you you have this background that you've been doing this. Was this always like you wanting to do this? Like you left high school knowing not so much in the mental space that you were going to go and deliver babies. Like I wanted to be in the healthcare space. Has that always been your thing? No. No, no. I barely made it through high school. I'm not kidding. Like I was only like complete threat from my dad that I made it through high school. I hated school and now I have two master's degree and a doctoral degree. So like yes no if you would asked me and I you know had my first baby at 20 was married you know at 19 you know I'm old like that and that's what we did back then. So anyway so I didn't even go to college until after I had two kids. Wow. So right I was a travel agent for a period of time before I went to school. Then I was a receptionist in a doctor's office and then I went to nursing school and you know then I went to then I actually opened a nonprofit and so that's where the business side of things kind of come out in me a little bit. I opened a nonprofit about if you don't mind me asking. Oh yeah sure. It was um pregnancy and breastfeeding education was also a lactation consultant. So it was a center where we did prenatal education did mom support groups. So there's some mental health piece in that part. Mhm. Um we also did lactation services so for moms who are breastfeeding needing support for that. Um and we did some basic like pren like um early childhood screenings and so forth. And then a local hospital system reached out to me and said would you come and do this programming for us on a much bigger scale. And so then I went into like the corporate side of healthcare um administration and kind of doing a much larger scale um version of what my nonprofit was. And then I wanted to do my master's degree because I realized I was being limited a little bit um in some of my advancement opportunities. And so I decided to do a clinical masters because you can always fall back on that. So that was for practicality and I was in the child birth and breastfeeding space. So that's when I decided to do midwiffery. So it wasn't like this deep longing calling. Yeah. You know where some people um you know can say oh from a little childhood I wanted to do that. a lot of my stuff was done practicality and then driven by my interests and like passions around it. Um, and so it's kind of I feel like your life has really taken full circle because you talked about starting a nonprofit. Now you guys are working with nonprofits. Yes. Um, to to find care available for first responders and vets. So I feel like, you know, sometimes we go through life to learn things and look where you're at today. Everything you've learned, all these experiences in life um, led you to this moment where you're doing something greater. Um, could we talk about the nonprofit? Don't we all do that though? True. No. Yeah. I mean, with a little bit of help, you know, I I I would say the reason that, you know, we talked about mental health, I wouldn't be here where I'm at today because of this if it wasn't for people that seen in me before I seen in myself, right? Seeing me for who I was and just meeting me where I was at and allowing me to know that listen, this is not who you are, it's what's happening to you. Mentioned the disease. A lot of people would say that it's it's they're not a bad person, right? There's something going on. we got to figure out what that looks like. So, yeah, we do have the chance. Um, it's just finding the right people that can help us sometimes get there because we can't always do it alone. Do you agree? 100%. And so, when people say I pulled myself up by my bootstraps, I would I mean, I making up numbers, completely making up numbers, but I would bet you 90% of those people aren't recognizing like small factors. Like I don't care if it was one teacher, if it was a minister, if it was a neighbor or a friend or something who taught them something to help them pull themselves out. Somebody who gave them some knowledge, a little bit of financial resource, some like support, gave them a place to live while they were getting their lives together, that kind of thing. Yeah. And yes, it's very much their hard work and their determination, but without that, like there has to be somebody who's pulling you up just a little bit and giving you just a little bit of a boost because without that, you can't you can't just spontaneously learn something or have something. You have to have somebody who's giving you a little push, a little incentive. And so that's the difference. And so um you know you you articulated it beautifully for yourself is that there was some people and so it doesn't demean the work that other people have done and yes it's a lot of bootstraps and I was a single mom and I went to college you know like there's all these things but there's little paths along the way that there was this one person who said you should do this and you should talk to this person or you should consider going to nursing school because this and if somebody hadn't told me that or really pushed me that way I had to do the work, but it was somebody who was kind of helping kind of push through that path a little bit. I love a story that you have, by the way. I'm pretty sure people don't know that story, but to be uh you said married at was it 19 19 a mom at 20 years old and this is where you're at today. Like I I have a a niece, she's about to be 21 years old and her her dad is just so livid because she's pregnant. But to me, this is a girl that's working. She came from Puerto Rico. We're living a different life here, a better life here. Um she's in school, right, to be a nurse. And it's like, can you really be mad at her? You know, I get she's so young. At the very beginning of this conversation when you were comparing your 20 21-year-old stories, right? I was pregnant with my second kid at 21. So, you know, what did I do on my 21st birthday? Not a damn thing. I wasn't in a car doing anything. I was pregnant with my second kid. Wow. You know, and so, yeah, like we all have these different stories and you don't know. and I didn't have a college education. I had the opportunity. My parents gave me that option. But like I said, I hated school. Did not want to be in school. I started I've been working since I was 15. You know that that's my, you know, path because I would not have been successful right away for college. So, I just want to make sure that my dad ever hears this or something that like I had the opportunity, but I chose not to take it. You know, I got married, had kids, that kind of stuff. And then later it made sense to me. But sometimes we got to take those detours that I'm one of those big things sometimes people have to see what rock bottom looks like, you know, for them to to realize this is not where I want to be, right? So it definitely wasn't a rock bottom. I just want to be clear that but it just was like okay like No, not for you in your case, but just in general some people, right, you don't have to wait for rock bottom to get help. You just have to care enough to start. Right. Right. I think you mentioned or you just have to experience things to decide, oh, this isn't really for me or if I want to do this, I'm going to have to do these things to get there. And so for me, I was like, unless I'm going to be working paycheck to paycheck all the time, yeah, I'm gonna have to do something different. That's it. No, for sure. You got to get sometimes uncomfortable to get comfortable. Um, you know, what does that look like? You could take that however you want to. It could be getting out of relationship, getting a new job, um, getting therapy, like whatever that may look like for some people. Sometimes you just got to get uncomfortable to get back comfortable. You're not in it alone. There's so many people going through it. There's so many resources out there um that could really help. You talked about the nonprofits helping our our our vets um to be able to get this help because there's so many of them that need the help but ideally feel it's too expensive. Right. Right. Uh and you guys are working with this nonprofit. Can you tell us how you guys are working with these nonprofits? Sure. I mean the veteran groups we have probably the most connections. There's a lot of people who really are connected to it and we're so thankful and grateful for, you know, the opportunity to be able to partner with different people to make sure that anybody who wants treatment has access to it and we do things like, you know, no cost ins, you know, no interest payments and we've, you know, done everything that we can and like I said, we decrease the cost of the things that weren't insurance covered. But that being said, it still costs something. Even if you have health insurance and you have co-pays and stuff, it it doesn't matter at what level, people still need help. So there are many nonprofits that, you know, help fund, you know, a few people here there and stuff, but the biggest one in Illinois right now is the 100 Club of Illinois. any first responder, they'll give up to $2,000 um towards any sort of our mental health treatments that we have for and they just have to be an active um first responder. So, police, fire, EMS, there's a whole list of people that qualify in that first responder list. Um and so we search for these opportunities, but some of them come to us. They're like, "Oh, we heard you're doing this and we have these people that aren't, you know, getting help elsewhere and we've worked um with some larger um entities that are funding treatment for the um special forces. So, people like the Navy Seals, the Green Berets. Unfortunately, the Veteran Administration doesn't have the manpower, staff, money, resources, or whatever it might be. they don't fund some of these treatments, even the stuff that's covered by traditional insurance um like um the nasal ketamine, TMS, it's very difficult for them to get through the VA. Um so we've partnered so that we can be part of the community outreach that they have. Um but not everybody who has trauma is veterans, right? And so um we have another couple nonprofits. The primary one is Erase PTSD Now. Anybody can apply there. And you know, so you may have to wait a little bit for funding to become available, but that you don't have to be a certain category, you know, or a veteran or a first responder because many people outside of those um areas also need treatment, too. So, we work really hard. We have a person in our, you know, staff that that's their whole job is partnering with things. And before I give you this last blind question, I got one question. I think there's a myth out there that you can bust for us. A lot of people think that when we think about seeking therapy, if it's too cheap, it's not good, right? And there's people there's doctors, if it's too cheap. If it's cheap, it's not good. Correct. But then I spoke to other doctors that created their own practices where this is what they do and they make it affordable. So at $99 a month, you can see this doctor as many times XYZ, right? Um it doesn't mean it's not a good doctor. They just made it more affordable. What is your thoughts when people think if you could just kind of talk to that people that think hey if it's too cheap is not good for me or is it too good to be true that's probably an easier answer um like because we get a lot of skepticism on that like this has worked so well or if this you know and I have to convince people too even that to take funding I'm like no really there's no catch to it the 100 club is going to pay for this for you and so they're too cheap to be true I think that, you know, we always are kind of have this skepticism behind us, but there are a lot of really great community resources in the mental health space that are doing a good job. Are they underfunded and maybe you can't see people as often or it's harder to get in? Yes, that's true. But that doesn't mean that they're not good quality services. There just not enough of them. Um, and some really expensive providers that we work with aren't doing a great job. some of the people that are coming from the, you know, VA or the social services administration like from free care to coming to us, their providers have been doing a great job and they're the ones that are linking them to us. So, it's not about the cost range. I think that there's really great providers on all ends of the spectrum. I think that the hard thing is is that we lose faith and trust that there's still options and that treatment can work and that it's exhausting to keep trying, right? Especially if you're dealing with mental health, you know, concerns, you've tried 10 times. Number 11 gets really hard and especially if you say it's going to be free or you're going to have to do this, but it's 80% effective. People are like, "Yeah, that's not true. that's not accurate. And you know then they see another provider that's another person that's not doing great. Sometimes they have to try 12 times before they find the right person who really understands what's going on. And so it's really difficult um in that way to continue to have faith when particularly in mental health like the big problem is that we don't believe and that we lose hope and we lose faith and we lose trust. and as part of the disease process. And so that's where it gets really difficult. But there is help available on all ends and free help. Maybe it's not the best help you've ever had. It's still help. And they may be able to connect you to somebody else like us who has a, you know, grant funded resource that can help them with something bigger because we get tons of referrals from agencies who are seeing people in really difficult situations. Such a great conversation. And we're almost at an hour here, believe it or not. I leave you with this last question. If you could go back to one delivery room and whisper whisper something into um your younger self's ear, what would you say about the journey ahead? Oh jeez. Me whispering to myself. Go back to that one delivery room when you were younger. I just think that what you're doing matters. Like it's really hard sometimes to keep that perspective because not every day is joyful and there's a lot of really hard days in between and I think you alluded to it that we all get into this space for our own personal reasons whether it's our own personal traumas our own like many people in healthcare in general have some stories to tell many people who've been in the military have stories to tell right and you don't do hard work like this if it doesn't mean something, right? Because it's not fun a lot of days. It's really rewarding. But that doesn't mean that it's fun or great all the time. Yeah. So on the really hard days or the times where you think I just I don't think I can do this is that you can and you know it's worth it in the long run. Love it. Dr. Dr. Stella, where can people find more information about what you guys Dr. Stellar Dr. I'll take it. Where can people find more information on what you guys are doing at Stella? Um, it's stellaalhealth.com. Um, but if you want to look up information on the Stella Ganglam block, Dr. Lipov is one of the really big re lead researchers on that. So, if you want to look at data on those sort of things, those are actually linked on our website, but you can find them elsewhere. But if you want to know about our company and all the things that we're doing, it's stellaalth.com. I appreciate you guys. My name is Ephra. This is Dr. Karen. Continue to share, like, and subscribe, and we'll catch you guys on the next conversation later. Thank you. Welcome back to another episode here on the heart and hustle podcast with Dr. Karen that said when I spoke to her, I used to deliver babies and now I help deliver themselves from trauma. The body always remembers but can also heal. What a strong just statement. Um, so you're no longer delivering babies. Is that correct? That's correct. Haven't delivered a baby since 2019. Wow. Do you miss it at any um moments, but I really have evolved from that position and not like evolved in a better way or something like that, but it's just, you know, evolution of my life work and kind of where I've gone from there. Um, so I miss moments of it, but I don't miss, you know, being up all night with, you know, missing my own family events and weekends and holidays and stuff because that's a job that does not have any hours and babies come when they want to come and so, you know, we all take turns on 24-hour shifts and, you know, somebody's got That's a question, Dr. Karen. I really want to know that because I've had two kids of my own, obviously, not me, my wife. you know how I was there and I remember one of our kids being born like 2 something in the morning and it's like we got to call the doctor and it's like the doctor just rolled out of bed or something. Are you guys sleeping at the hospitals? Yeah, we can sleep at the hospitals um if we have um other patients there and depending on like how big your practice is or if you don't live within a certain amount of time. So like if you're more than 15 minutes away from the hospital, you have to be there during your call time. Um, but if I have multiple patients and I have a 24-hour shift, like, yeah, I sleep. There's little call rooms there, little teeny bunk rooms that have, you know, just little single twin beds in them and it's a way to lay down and you take an hour where where you can if you need to because it's I don't think people realize that. I didn't notice that. And then when my doctor comes in at 217 in the morning and I can see she's just kind of rubbing her eyes and everybody's doing the work and she's just sitting there. I'll tell you though, I'll tell you the story real quick. we get into what you're doing today. But, um, I'm watching her. She looks very tired, you know, but she was so on point. And my wife was like, she said, "First put a mirror here, then she put the mirror, then she starts to throw up." And I guess once she's throwing up, the baby pushed out in seconds. And the doctor was immediately on it. Like, no one noticed that the baby was out, but the doctor was on it. And I'm like, shout out to the doctor that just rolled out of probably the bed with a 30 minute nap, baby. Because it was during a pandemic. So just imagine they were inducing people at this point to try to get beds available. So it was pretty crazy time. So I can imagine she but she was so kind, just so good at what she did. Um and respected her for that because you guys really it's a good provider that you really don't notice them in the room so they're not being intrusive and things. Um so that's actually a hallmark of a good provider because you know you don't want to be adding to the chaos. You don't want to be adding to the hustle in the room, but you're there purely observing, doing what you need to do and focused on what you need to do. And that was a perfect example of that, right? Like everybody else is like doing little things and stuff and forgettingthat the patient's right there having her baby in the meantime, right? And yeah, you know, but I miss those little things. Yes. But yeah. Yeah. I can imagine, you know, seeing the smiles on people's faces. I mean, and there's also some, as you mentioned, there's trauma that goes on, not even from just that moment that they're in the hospital being delivered, but then life happens. There's trauma through a child's life. And I think I kind of spoke a little bit on mine on what I've encountered, the sexual abuse, the adoption. And Dr. care and the more that I do this and the more that I share my testimony realizing that there's so much trauma going on at different levels. Why why did you get into this space after going to deliver babies where you get happy moments and then now you're in the space where you have to listen to some of these stories that you have to take home and and sometimes it's very um heavy. Yeah. Well, it's interesting. Trauma is everywhere, right? And so when people would say to me, "Oh, you get to deliver babies. It must be such a nice job and stuff." That's a very teeny teeny window of what we do, right? That's a teeny teeny teeny part of what we do. We take care of women throughout their lifespan, pregnant, not pregnant, you know, through their pregnancies, you know, after they have the babies. And unfortunately, not all births are happy and easy and good. And there's a lot of, you know, issues leading up to the pregnancy. There's a lot of stuff kind of this answers a little bit of both questions in that there's a lot of family stuff that comes up. There's a lot of um you know women facing their own traumas. Um maybe you know sexual traumas related but it could be family dynamics. You know this is they've never had any attention paid to them but now they're having a baby. suddenly they're in the spotlight and you know so it just there's so much family stuff that comes out and then there's family politics who's going to be with the mom who's not and we don't like the father we this we that like so much drama and tension sometimes um and you know not all births are positive outcomes you know thankfully it's a really small amount um but not all pregnancies are happy um there's an increase in domestic violence um during um pregnancies disase like almost threefold. Um, so there's a lot of stuff that goes on and people don't stop being people just because they're pregnant, right? So there's mental health, mental illness, addiction, and things that are all happening in a woman's life before pregnancy are still there during her pregnancy, and we have to help manage that during that time. And I think when you and I first talked, you asked me about that and the population I was taking care of, there was a lot of substance abuse. It was in a very poor, you know, economically challenged um environment and there was a lot of drug use, a lot of mental health, very little resources. So, we had to be the people to take care of the women who were pregnant because there was no mental health care providers. And so, you know, we were the ones that had to do that piece of it, too. So, mental health is part of any bit of nursing, right? And um you know, and any part of life, you just mentioned it, the people you've talked to, you're noticing it. I think what's surprising is when there's not, you know, kind of dramatic stories in the background. That's it's it's absolutely the minority of people have had very idealic, very unchallenged lives to make it all the way to adulthood and not have, you know, some level of stuff happening. And it could be for a brief period of time. It could be kind of this small stuff, you know, ongoing. It could be just a a life of poverty, a life of, you know, um, racial tension, whatever it may be. It doesn't have to be somebody's being beaten or abused or something. The the challenges, and we talk about that like in different other socioeconomic pieces, you know, little access to good health care, little access to good education are all traumatic. It's just in different pieces and different levels and scales, right? there's not really a comparison. Um, and you know, but it's part of everyday life, right? Love it. No. Yeah, you're right. There's there's a little bit of everything. And um, everybody's life is just very different. And I tell you how this is just having a conversation with a neighbor. Um, I always love to talk about life and where people are at. And it was the holidays. I come over with a a drink, alcoholic drink to my neighbor's house. And one neighbor, my neighbor that lives there, he always says like, "No, I'm good." Older guy, um, almost 50. And then then he he had a friend older guy almost 50. Oh my god. The kid stop it. I miss it until he's 49. I said you're 50. He's like I'm 49. I'm like I mean ground it up. You're 50 years old. He hates it. But um no I his friend 35 years old and I went over a drink. He's like I don't drink. I'm like like you don't drink at all? He's like I'm 10 years sober. He's 35 years old. I'm like what? Like by choice? Like what happened? And so he started telling me a story. So we were just talking about our 21st birthday. He's like, I spent my 21st birthday in rehab. The other person spent their 21st birthday in the military. I spent 25 birthday my 21st birthday living my life. But you can see how everybody's is very different. Everyone's life is very different. The question I asked them, Karen, was um I didn't have, you know, I was adopted. I life was lifeing for me. But they I knew they had both parents. So I said, "With you guys having both parents, what made you what made you get into like drugs? Why why do you think that was it?" Because it wasn't just alcohol. It's when he started drinking. When he started drinking is when the drugs started to also take play and the drugs were taking over his life, you know? Um and he didn't get sober till he was 25. And um he's like, you know, I had too much freedom. My mom had to work two, three jobs and I was just in the wrong crowds, right? So sometimes we think someone looks great cuz they have mom and dad and they look sharp at school or whatever the case is, but they go home and you kind of mentioned it, people don't don't they don't get attention until that moment of being a parent and all of a sudden there's attention there and they don't even know how to deal with that and there there's all these things that's kind of probably been swept under the rug. Do you feel that that's what kind of led you as you're hearing and seeing these things in the hospital rooms um led you to the to go and make the transition? Um that's an interesting question. Um I don't know that there was any one pivotal thing, right? Um all of nursing, all of health care is really dealing, it's not just somebody's disease of the moment, right? It's not somebody's cancer. It's like what are their household resources? Are they going to have somebody to be able to drive them back and forth to treatments? Can you know like are they able to leave their work? Right? There's so much socioeconomic life stuff and it's not even a that's not even like a poverty thing, right? Like so I talked about one time that I couldn't take the time to do one of the treatments that we offer. I could, but it would be really difficult, right? Like with my work schedule, it's a daily thing that you have to do for 36 days. And you know, it's like so even though it's a short interruption, how do you interrupt your day like that to go to a place for treatment and come back? and we underestimate how much of a commitment life, you know, like all these treatments and things are. So to kind of bring that back together is that we're always navigating that as healthc care providers, right? And I can write you a prescription, but if you don't you can't pick it up, then you know it's no good, right? And I would go to write a prescription. I was like, are you going to be able to pick this up? Are you willing to take it? Like I had to like over time I learned to ask my patients is it worth even writing this because if it if they're not going to do it either because they don't want to or they can't financially they don't like then I have to come up with another creative way to properly solve that problem if possible right versus thinking I'm just going to write this prescription they're going to get it they're going to take it and things are all going to be good. And so we're always juggling that and we're always having to think through those pieces and that's part of people's mental health too, right? And I think that you touched on this on a prior podcast is that mental health is part of our body, right? Like so how how is our brain and our nervous system working together to help us optimally live and live symptom free, right? And so we can't ignore any body part. We can't say, "Oh, well, I'm only worried about pregnancy. I'm not going to worry about the person's heart. I'm only worried about the pregnancy. I don't care how her lungs are performing." Nope. I need a heart that's working well and lungs that are working well to, you know, so everything is essential. And so looking at things from that perspective, um, healthc care is always dealing with all of general body care. And so the brain is arguably probably the most and the nervous system are probably the most important, right? If you have brain death, nothing else works, right? You can live with fake artificial this and that and you replace different parts, but you can't replace a brain. You can't replace a nervous system. And so those have to be optimally working. And I just kept seeing that more and more and more and more. And those are the things that weren't paid attention to. Um, and you know, I think I'm really deviating from the question that you asked me. Good question. Actually, I'm I'm kind of add on to that. You keep talking about um, just providers, right? And earlier you mentioned a good provider, and obviously in anything, there's going to be the good, there's going to be the middle, there's going to be just flatout bad. What do you wish more providers actually understood about trauma and behavior? Because you mentioned it is so important to understand that because it's just more than just a pregnancy, right? Oh gosh. um trauma and behavior is that when people have like chest pain, right? They we can be sympathetic. You're like, "Oh, you can see them, you know, having this agony and you're like, oh, what's wrong?" You want to comfort them and you want to help take care of them. But we have a really weird reaction when somebody starts acting behaviorally different, like really anxious or angry or, you know, it's really challenging. It's really hard for us to look at that emotional or those behavioral things that we see that come along with when the brain or the nervous system isn't functioning optimally. You know, if somebody's anxious or somebody's, you know, distressed and acting out and things, it's much more difficult for us to separate our emotions. We can say, "Oh, I'm sorry your heart hurts." Or, "I'm sorry that your leg, you know, was broken and you're having this pain." pain and we have this empathy for that. But I wish that people realize that the behaviors and the symptoms that we see somebody who's depressed or anxious is no different than somebody having pain in their arm or their leg or something. It's just telling us that something's wrong. They're not willfully doing these things just like somebody not willfully having pain in their chest. Yeah. And so I think for so long we looked at the behaviors as the problem and that's the issue, but it's not the behaviors aren't the issue. The issue is something's wrong with the brain or the nervous system that's creating that behavior. And instead of trying to think they're behaving poorly, what's what's causing that? Somebody isn't behaving poorly because their heart hurts, right? It's just a different set of symptoms that are showing up. And um I think it's because it changes personality or it's more difficult to deal with. We feel uncomfortable. But if you can separate the behavior or the expression of these symptoms and realize that's coming from the same place of some part of the body isn't functioning right. Um otherwise that wouldn't be going on for them. Right. And so that's what I really wish people understood. Hey, real quick. Have you enjoyed the podcast? We first want to say thank you and we also just want to give you a little insight of what we're up to at Francis. Some even realize that we're working with organizations to help them use AI to create that real human communication experiences where that's actually supporting your your families, those patients or the entire community. We're actually creating tech that connects. Check it out. Francis.ai. Dr. Karen, you mentioned um earlier just like medication, someone not being able to take it because of financial reasons or whatever the reasons may have really been that they don't want to take them. Is there holistic ways that people without medication? I think like myself, I'll be quite frank, I hate taking pills, so uh whether it's a vitamin, you know, like now I take vitamins because I'm a little older. I'm 35, Dr. Karen. Okay, a little older. Uh but I hate taking these vitamins. A matter of fact, do I got some on my desk? They're just so big. But is there anything that people can actually do when in instead of taking medication um are you guys in that space of finding other ways? Absolutely. So, but I also want to be very clear that medications do serve a really good purpose and a really good function too, right? And so again going back to the body like we don't say gosh I if somebody has high blood pressure you know yes you can diet you can exercise you can lose weight you can stop smoking you can do all these other things right but at some point those things may not work for everybody or their body may have gotten to a point where you know those changes aren't enough. Maybe they have a genetic you know um indication that their blood pressure is higher. It's a, you know, something that they're completely not in control of. So, we need a medication to help control those blood pressure symptoms. So, again, it's no different for a medication that helps somebody's anxiety, depression, or even more importantly in in disorders like schizophrenia and things like that. There's no diet fix. There's no anything along that line. So mental health medications are no different than somebody taking something for their diabetes or for their, you know, high blood pressure, it's really zero difference. And so if you're going to stigmatize somebody taking a medication for the mental health symptoms that help them sleep, that help them be more functional, that help them keep, you know, the, you know, like their emotions regulated, those pieces. How is that any different than somebody who's taking something to keep their blood sugar in check because their pancreas isn't working right? And so sometimes there are things that we can do, diet and stuff. Those things are extremely important and talk therapy is extremely important, but there are underlying things that right now we can't change without the use of medications. And so it's not just taking a pill. It's not a fault. It's not a it's not a escape. It's not like a cheat or something um any more than taking, you know, an antibiotic for an infection is really. And so I really really hope that people don't could get past the idea that taking a medication for that. If you don't have enough vitamin D in your body and you take some vitamin D, is that a weakness? No. That's a strength because you're doing you're providing your body what it needs to be optimally healthy, right? And so the people who take medications, you know, that's the same thing. But yes, there are things that we can do that aren't medicationbased. And a lot of people think that you have to be extremely ill for some of our treatments like ketamine or TMS. Um, and we can get into that if you want to talk about the different modalities, but yeah, there's a whole spectrum, but meds are not the enemy. It's just unfortunately in psychiatry many people don't know that there's lots of other options that aren't meds only or they use meds and they try meds and try meds and try meds for way too long or put people on way too much or way too many at the same time. It's about using them wisely and when needed. But there's no fault or no problem with that when people do need them. Love it. Which is why you guys are on this national movement. You guys organization that you're with is Stella. Um, and you mentioned we're not here to replace medication. We're just here to give people more options and more hope kind of what we're just talking about now. So when we in that space, what's the origin story behind Stella for those that may not know? What made you join the mission? I mean, not such a career change. You're in the healthcare space, but there was obviously a reason why you decided this is a great organization to to be a part of, right? So I joined Stella really early. Um, the company actually originated in the year 2000. um or sorry 2000 jeez 2020 and um I was thinking I was like wait a minute I think it was like grow do I know more about your organization here right so in 2020 but it was um funded founded by um our CEO Michael Gersonen and um the origin story is that he was part of you know he was called himself a finance bro was part of venture capitalism and you know like funding organization and really did amazing things in that space. Um but then he had the death of a friend. Um that kind of opened his eyes to kind of some things that he had not been exposed to really. Yeah. And right before that death he had that person that died um had introduced him to Dr. Lipoff which is the founding um medical officer for Stella and was talking about some things that could be done you know in this space for people who are really suffering and in retrospect this guy was really suffering and he just wasn't able to access the services before it was too late for him um and so that really kind of pushed our CEO um into looking at what could he do to enter this space and so he jumped in you know head first and even though it wasn't his area of knowledge or this area of comfort. He said, "I want to do something here. I have the capacity to partner with somebody who has the knowledge, the medical skills and so forth. I have the business skills. Let's see what we can do." Um, and then in 20 three, I actually had some patients that I met through um the a program at Rush called at Rush University Medical Center here in Chicago. I was working in a veterans program um for severe post-traumatic stress injury. We were doing a two-eek intensive program where people come from all over the country, spend two weeks with us at Rush. And some of my worst cases, who I was really felt super stuck with as far as I don't know what else to do or what else to offer this person, had treatment with Dr. Lipov at Stella and I was like, what is that? And here I am at a big university medical center, not some little, you know, out of the way practice where I don't know where I'm not being exposed to things. And I was like, how do I not know more about this? And so then I really started doing research into what it was the stellate ganglen block. How did it work? And I then I started to get mad because I thought, how do how am I a professor in this arena in psychiatry working at a really premier medical institution? and how do I how am I not aware of some of the things that are happening in this space and so that led me to actually wanting to try the treatment for myself because I I couldn't understand it didn't really it was really hard for me to wrap my head around and that's just the kind of person I am and so you know I did it out of curiosity had my own stuff like health things and family things I wasn't in a space where you know my patients were but I thought well worst it's going to do is nothing but I want to have the experience experience. And so that's how I met Dr. Lipov. And then about six months later, Stella really wanted to turn the company around and they reached out to me and said, "We really, really want to expand our programming, our offerings, and really get into the full mental health space versus just doing this one procedure." And so that's where I kind of entered into the company itself. Yeah. Yeah. And Michael, great. I mean, he he acts like he doesn't know much, you know, to him. You you ask him and he's telling you, "I'm new at this, right? But I learned so much from him as well. You can tell he's really dived into this and learned so much from it. I ask you, how does that uh gangelian block actually work for trauma? So um the simple version and the non-scientific explanation that I try and use in my elevator speech is that we have a bundle of um nerves called the stellate ganglen nerve bundle here. We have it both on the right side of our neck and the left side of our neck. And it's basically the control center that primes our body for fight orflight response. Right? So the flee, run away, fight, um protect yourself, right? And so this is kind of the central warehouse for that signaling. Okay? And over our lives, we get exposed to little things, whether um it's a big trauma, little trauma, or just plain old learning. Right? If you throw a ball at a baby, they don't put their hands out to catch it, right? It dons them in the face. You're like, "No, no, put your hands out like catch catch it, right?" Yeah. And they have to learn to do that. But over years, you learn to duck when something comes at you, right? Because those exposures teach you something's flying at you, you need to duck or it's going to hit you, right? And so those are all learned behaviors from our nervous system to keep us safe. the same idea of like a hot stove. Kids put their hands on the hot stove. You do that a few times, you learn, right? And right now, if I told you like even kind of conjure the image of like a burner on a stove that's hot, flames, and I said, "Put your hand there." How does that feel? I said, "Put your hand in there." You have like this little like I don't want to. Right. Yep. Yep. And I promise you, if I was standing there and I said, "Put your hand in there." and I tried to push your hand into it. You would absolutely positively not want to put your hand into it, right? You would fight me. You'd want to pull it away, but there's nothing that's saying you can't do it. You absolutely there's nothing physically stopping you, right? Yeah. But your nervous system is saying don't don't do it. Don't do it. Don't do it. Right. And so it's very much that central nervous system learning from exposures to keep us safe. Right? So those are very practical things. Baby stick your hand out so the ball doesn't hit you. You learn to duck. You learn to move. So those are learn behaviors. Don't touch the hot thing. And it becomes so like offensive to you. Like it gives you cringey even thinking about putting your hand in that fire, right? But you could physically there's nothing stopping you just like you wouldn't have to duck if something was flying at you. So when we learn and have these repetitive exposures to things, we adapt to them because our nervous system is there to keep us safe, keep us protected, and make sure that we're safe, right? Yeah. When you've had a bad exposure, just because you're away from it, your nervous system still remembers that kind of situation is like, "Oh, be careful there. That seems similar, too." And these are all things that we're not really aware of, right? It's this signaling that says, "Oh, there's something moving around in the periphery. make sure that you're careful. It could come at you. Those sort of things. So, all this stuff is happening in our subconscious. When you've had lots and lots and lots of exposures to lots and lots of different things, you get really good at protecting yourself, right? And so, it's the same thing like a soldier doesn't think a firework is a gunshot. They know it's not. And that so this is where people get like, oh, they think they're hearing gunshot. No, they don't. They know that it's fireworks, but their nervous system is hearing that and is reminding them of the time. So, they're on this alert, that sound, even though cognitively they know it's not a problem, their nervous system is like, "Whoop, be careful. Be careful." And just like you felt queasy think about putting your hands on on a burner, it's the exact same thing that goes on in a much larger scale for people who've had exposures to lots of small traumas, one big trauma. Your nervous system is there to protect you. So this is the whole buildup for this, right? So that nervous system is constantly feeding the brain. And when you've had so many exposures, we kind of have this tipping of the scale where we no longer get to think about things first. It actually bypasses the thinking part of the brain so that we can react that much quicker and that much faster. Right? So the stellate block actually just anestizes that nerve bundle. doesn't block it permanently. It doesn't turn it off permanently. It basically rests it and says, "Hey, let's get out of this over excitement, this overfly wheel of sending information non-stop rapid fire without thinking of it and giving your body that chance to reset and to rest a little bit. So that when it comes back online, as the anesthetic wears off and goes back through the brain processing, it goes through the part of the brain that can think, "No, that's not gunfire. That's a a firework, and I don't have to have this trauma response." Because what happens is when we get over excited, it goes straight to the amydala, the the fight orflight part of the brain where we're having these reactions that we can't control. So the stellate block is a twominute procedure that anesthetizes these nerve bundles, the stellate nerve bundles, just like when you're getting dental work, right? So it the anesthesia stays there for a little bit, but it allows that nerve bundle to rest and we call it a reset. So that when it starts to fire again, it fires in the normal pattern where, oh, there's a problem. Let me think about it. Is it real? No. Okay. And so you don't have to have reactions that are so extreme to something that's really small. And so it's a very very very simple procedure and works about 80% of the time. Now you said this is only two-minute procedure. Yep. Wow. Yep. Is this is this what's different between what you guys are doing and other traditional mental health clinics or is this what's like I know I I haven't physically been to a mental health uh clinic nor have I ever heard of what you guys are doing. Is this what sets you guys apart? I think what sets us apart is that we have access to lots of different treatments. This is the only treatment that we do. Right. I said we prescribe medications. We do you know trans um magnetic cranial stimulation. So, we stimulate the brain with a magnet pulse that increases the blood flow covered by insurance. We do the ketamine nasal spray. We're agnostic, but we have access to things that are not as commonly prescribed and used. And we have really strong skill set at looking at who would do best from what treatment. We don't try and treat everybody with just one thing. Got it. Not everybody gets therapy only or medication only or ketamine only or not everybody needs the SGB. We have people that come to us that I say, you know what, I don't know that that's going to really address what's going on for you. And you know, so we have really clear um guidelines. We have tons of data, tons of research and really clearly skilled clinicians that will look at everything that's going on with the patient, what they've tried, what they've done, what are their symptoms, as opposed to saying, "This person has, you know, depression, this person has anxiety." It's never that clear. So, we say, "What are the big symptoms that this person is suffering with?" And use that as a clue as to how we might want to treat them. And so we have access in one place, skilled clinicians that understand all those treatments and use them most effectively for patients as soon as appropriate and don't look at things like oh we only do that in the worst case or you know different things where many providers don't have access to certain treatments and so they get really really stuck in this spot of using only one modality because they don't know how to get somebody something else or like me who was like, "What are you doing? You're doing a shot where?" And you know, and this is not that long ago, right? And Dr. Lipov actually did a lot of his research at Rush. And here I'm at that university and how do I not know about it? Yeah. And so we have access and knowledge to a really wide range, which is what I think makes us different. There's other people doing each of the things that we do, but in really segmented ways. How would you say that you guys are um because you guys are scaling in five years, you mentioned 2020 was the start of it all. You guys are truly scaling throughout the nation. How are you keeping your cost down as well while scaling? So actually it's the scale of economy is really helped and um uniquely we've actually been able to lower the cost of the non- insurance covered treatments by expanding our treatment offerings by doing things like med management therapy TMS the nasal ketamine all covered by health insurance we were able to decrease not quite by 50% but close um our costs on the stellic ganglen block or the IV ketamine we were able to bring those costs down because we're now offering a wider range of modalities that are covered by health insurance. And if you have to have a call center that's answering phone calls, answer that same person can answer for three sites the same as they can answer for one, right? And so scale of economy is is you are able you're doing the same processes and you're you know marketing people if they're marketing for two locations or five you know it's you don't have to like have new duplicate everything for every single location. I don't know if that helps. Okay. No no it does. It makes complete sense. Yeah. Um I love this. I'm learning so much and I know you you were a little nervous that I wasn't going to learn from you the same way that I learned from Michael, but I'm I'm learning a lot here because it is you you have this background that you've been doing this. Was this always like you wanting to do this? Like you left high school knowing not so much in the mental space that you were going to go and deliver babies. Like I wanted to be in the healthcare space. Has that always been your thing? No. No, no. I barely made it through high school. I'm not kidding. Like I was only like complete threat from my dad that I made it through high school. I hated school and now I have two master's degree and a doctoral degree. So like yes no if you would asked me and I you know had my first baby at 20 was married you know at 19 you know I'm old like that and that's what we did back then. So anyway so I didn't even go to college until after I had two kids. Wow. So right I was a travel agent for a period of time before I went to school. Then I was a receptionist in a doctor's office and then I went to nursing school and you know then I went to then I actually opened a nonprofit and so that's where the business side of things kind of come out in me a little bit. I opened a nonprofit about if you don't mind me asking. Oh yeah sure. It was um pregnancy and breastfeeding education was also a lactation consultant. So it was a center where we did prenatal education did mom support groups. So there's some mental health piece in that part. Mhm. Um we also did lactation services so for moms who are breastfeeding needing support for that. Um and we did some basic like pren like um early childhood screenings and so forth. And then a local hospital system reached out to me and said would you come and do this programming for us on a much bigger scale. And so then I went into like the corporate side of healthcare um administration and kind of doing a much larger scale um version of what my nonprofit was. And then I wanted to do my master's degree because I realized I was being limited a little bit um in some of my advancement opportunities. And so I decided to do a clinical masters because you can always fall back on that. So that was for practicality and I was in the child birth and breastfeeding space. So that's when I decided to do midwiffery. So it wasn't like this deep longing calling. Yeah. You know where some people um you know can say oh from a little childhood I wanted to do that. a lot of my stuff was done practicality and then driven by my interests and like passions around it. Um, and so it's kind of I feel like your life has really taken full circle because you talked about starting a nonprofit. Now you guys are working with nonprofits. Yes. Um, to to find care available for first responders and vets. So I feel like, you know, sometimes we go through life to learn things and look where you're at today. Everything you've learned, all these experiences in life um, led you to this moment where you're doing something greater. Um, could we talk about the nonprofit? Don't we all do that though? True. No. Yeah. I mean, with a little bit of help, you know, I I I would say the reason that, you know, we talked about mental health, I wouldn't be here where I'm at today because of this if it wasn't for people that seen in me before I seen in myself, right? Seeing me for who I was and just meeting me where I was at and allowing me to know that listen, this is not who you are, it's what's happening to you. Mentioned the disease. A lot of people would say that it's it's they're not a bad person, right? There's something going on. we got to figure out what that looks like. So, yeah, we do have the chance. Um, it's just finding the right people that can help us sometimes get there because we can't always do it alone. Do you agree? 100%. And so, when people say I pulled myself up by my bootstraps, I would I mean, I making up numbers, completely making up numbers, but I would bet you 90% of those people aren't recognizing like small factors. Like I don't care if it was one teacher, if it was a minister, if it was a neighbor or a friend or something who taught them something to help them pull themselves out. Somebody who gave them some knowledge, a little bit of financial resource, some like support, gave them a place to live while they were getting their lives together, that kind of thing. Yeah. And yes, it's very much their hard work and their determination, but without that, like there has to be somebody who's pulling you up just a little bit and giving you just a little bit of a boost because without that, you can't you can't just spontaneously learn something or have something. You have to have somebody who's giving you a little push, a little incentive. And so that's the difference. And so um you know you you articulated it beautifully for yourself is that there was some people and so it doesn't demean the work that other people have done and yes it's a lot of bootstraps and I was a single mom and I went to college you know like there's all these things but there's little paths along the way that there was this one person who said you should do this and you should talk to this person or you should consider going to nursing school because this and if somebody hadn't told me that or really pushed me that way I had to do the work, but it was somebody who was kind of helping kind of push through that path a little bit. I love a story that you have, by the way. I'm pretty sure people don't know that story, but to be uh you said married at was it 19 19 a mom at 20 years old and this is where you're at today. Like I I have a a niece, she's about to be 21 years old and her her dad is just so livid because she's pregnant. But to me, this is a girl that's working. She came from Puerto Rico. We're living a different life here, a better life here. Um she's in school, right, to be a nurse. And it's like, can you really be mad at her? You know, I get she's so young. At the very beginning of this conversation when you were comparing your 20 21-year-old stories, right? I was pregnant with my second kid at 21. So, you know, what did I do on my 21st birthday? Not a damn thing. I wasn't in a car doing anything. I was pregnant with my second kid. Wow. You know, and so, yeah, like we all have these different stories and you don't know. and I didn't have a college education. I had the opportunity. My parents gave me that option. But like I said, I hated school. Did not want to be in school. I started I've been working since I was 15. You know that that's my, you know, path because I would not have been successful right away for college. So, I just want to make sure that my dad ever hears this or something that like I had the opportunity, but I chose not to take it. You know, I got married, had kids, that kind of stuff. And then later it made sense to me. But sometimes we got to take those detours that I'm one of those big things sometimes people have to see what rock bottom looks like, you know, for them to to realize this is not where I want to be, right? So it definitely wasn't a rock bottom. I just want to be clear that but it just was like okay like No, not for you in your case, but just in general some people, right, you don't have to wait for rock bottom to get help. You just have to care enough to start. Right. Right. I think you mentioned or you just have to experience things to decide, oh, this isn't really for me or if I want to do this, I'm going to have to do these things to get there. And so for me, I was like, unless I'm going to be working paycheck to paycheck all the time, yeah, I'm gonna have to do something different. That's it. No, for sure. You got to get sometimes uncomfortable to get comfortable. Um, you know, what does that look like? You could take that however you want to. It could be getting out of relationship, getting a new job, um, getting therapy, like whatever that may look like for some people. Sometimes you just got to get uncomfortable to get back comfortable. You're not in it alone. There's so many people going through it. There's so many resources out there um that could really help. You talked about the nonprofits helping our our our vets um to be able to get this help because there's so many of them that need the help but ideally feel it's too expensive. Right. Right. Uh and you guys are working with this nonprofit. Can you tell us how you guys are working with these nonprofits? Sure. I mean the veteran groups we have probably the most connections. There's a lot of people who really are connected to it and we're so thankful and grateful for, you know, the opportunity to be able to partner with different people to make sure that anybody who wants treatment has access to it and we do things like, you know, no cost ins, you know, no interest payments and we've, you know, done everything that we can and like I said, we decrease the cost of the things that weren't insurance covered. But that being said, it still costs something. Even if you have health insurance and you have co-pays and stuff, it it doesn't matter at what level, people still need help. So there are many nonprofits that, you know, help fund, you know, a few people here there and stuff, but the biggest one in Illinois right now is the 100 Club of Illinois. any first responder, they'll give up to $2,000 um towards any sort of our mental health treatments that we have for and they just have to be an active um first responder. So, police, fire, EMS, there's a whole list of people that qualify in that first responder list. Um and so we search for these opportunities, but some of them come to us. They're like, "Oh, we heard you're doing this and we have these people that aren't, you know, getting help elsewhere and we've worked um with some larger um entities that are funding treatment for the um special forces. So, people like the Navy Seals, the Green Berets. Unfortunately, the Veteran Administration doesn't have the manpower, staff, money, resources, or whatever it might be. they don't fund some of these treatments, even the stuff that's covered by traditional insurance um like um the nasal ketamine, TMS, it's very difficult for them to get through the VA. Um so we've partnered so that we can be part of the community outreach that they have. Um but not everybody who has trauma is veterans, right? And so um we have another couple nonprofits. The primary one is Erase PTSD Now. Anybody can apply there. And you know, so you may have to wait a little bit for funding to become available, but that you don't have to be a certain category, you know, or a veteran or a first responder because many people outside of those um areas also need treatment, too. So, we work really hard. We have a person in our, you know, staff that that's their whole job is partnering with things. And before I give you this last blind question, I got one question. I think there's a myth out there that you can bust for us. A lot of people think that when we think about seeking therapy, if it's too cheap, it's not good, right? And there's people there's doctors, if it's too cheap. If it's cheap, it's not good. Correct. But then I spoke to other doctors that created their own practices where this is what they do and they make it affordable. So at $99 a month, you can see this doctor as many times XYZ, right? Um it doesn't mean it's not a good doctor. They just made it more affordable. What is your thoughts when people think if you could just kind of talk to that people that think hey if it's too cheap is not good for me or is it too good to be true that's probably an easier answer um like because we get a lot of skepticism on that like this has worked so well or if this you know and I have to convince people too even that to take funding I'm like no really there's no catch to it the 100 club is going to pay for this for you and so they're too cheap to be true I think that, you know, we always are kind of have this skepticism behind us, but there are a lot of really great community resources in the mental health space that are doing a good job. Are they underfunded and maybe you can't see people as often or it's harder to get in? Yes, that's true. But that doesn't mean that they're not good quality services. There just not enough of them. Um, and some really expensive providers that we work with aren't doing a great job. some of the people that are coming from the, you know, VA or the social services administration like from free care to coming to us, their providers have been doing a great job and they're the ones that are linking them to us. So, it's not about the cost range. I think that there's really great providers on all ends of the spectrum. I think that the hard thing is is that we lose faith and trust that there's still options and that treatment can work and that it's exhausting to keep trying, right? Especially if you're dealing with mental health, you know, concerns, you've tried 10 times. Number 11 gets really hard and especially if you say it's going to be free or you're going to have to do this, but it's 80% effective. People are like, "Yeah, that's not true. that's not accurate. And you know then they see another provider that's another person that's not doing great. Sometimes they have to try 12 times before they find the right person who really understands what's going on. And so it's really difficult um in that way to continue to have faith when particularly in mental health like the big problem is that we don't believe and that we lose hope and we lose faith and we lose trust. and as part of the disease process. And so that's where it gets really difficult. But there is help available on all ends and free help. Maybe it's not the best help you've ever had. It's still help. And they may be able to connect you to somebody else like us who has a, you know, grant funded resource that can help them with something bigger because we get tons of referrals from agencies who are seeing people in really difficult situations. Such a great conversation. And we're almost at an hour here, believe it or not. I leave you with this last question. If you could go back to one delivery room and whisper whisper something into um your younger self's ear, what would you say about the journey ahead? Oh jeez. Me whispering to myself. Go back to that one delivery room when you were younger. I just think that what you're doing matters. Like it's really hard sometimes to keep that perspective because not every day is joyful and there's a lot of really hard days in between and I think you alluded to it that we all get into this space for our own personal reasons whether it's our own personal traumas our own like many people in healthcare in general have some stories to tell many people who've been in the military have stories to tell right and you don't do hard work like this if it doesn't mean something, right? Because it's not fun a lot of days. It's really rewarding. But that doesn't mean that it's fun or great all the time. Yeah. So on the really hard days or the times where you think I just I don't think I can do this is that you can and you know it's worth it in the long run. Love it. Dr. Dr. Stella, where can people find more information about what you guys Dr. Stellar Dr. I'll take it. Where can people find more information on what you guys are doing at Stella? Um, it's stellaalhealth.com. Um, but if you want to look up information on the Stella Ganglam block, Dr. Lipov is one of the really big re lead researchers on that. So, if you want to look at data on those sort of things, those are actually linked on our website, but you can find them elsewhere. But if you want to know about our company and all the things that we're doing, it's stellaalth.com. I appreciate you guys. My name is Ephra. This is Dr. Karen. Continue to share, like, and subscribe, and we'll catch you guys on the next conversation later. Thank you.

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