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Why Ketamine? 

We are currently experiencing a renaissance in the treatment of mental health disorders, one that has been attempted but derailed in the past. The use of ketamine to treat addiction, mental disorders and imbalances, along with similarly non-pharmaceutical treatments, such as MDMA and psilocybin, is now more than ever being considered as a valid and superior alternative over potentially damaging pharmaceuticals that come with a multitude of undesirable side-effects. 

Traditional use of SSRI’s (Selective Serotonin Reuptake Inhibitors), like Prozac, Lexapro, and Zoloft, which seem to alleviate symptoms but do not result in transformative experiences, has been heavily and increasingly relied upon in the last few decades. Unwanted side-effects (anorgasmia) are not the only concern. All too often, medications are dispensed without the pairing of psychotherapy—what most people recognize as counseling or “talk therapy,” where one speaks to a therapist about their thoughts, feelings, behaviors, and therefore has the opportunity to learn new ways to cope and improve their life. The addition of ketamine to talk therapy further enhances this experience by helping to temporarily diminish or remove our minds’ inherent defense mechanism—the ego. Ketamine allows our conscious (aware mind) to communicate to our unconscious (unaware mind) without a filter. This allows profound insight to take place in a relatively short amount of time–something that would be difficult for many individuals to obtain with talk therapy alone.

 

A Brief History of Ketamine

In 1964, ketamine was first used on human test subjects with the goal of surgical anesthesia. in 1966, Parke Davis patented ketamine under the brand name Ketalar for use as an anesthetic in humans and animals. As a part of its development, ketamine was successfully used on American soldiers in the Vietnam War. Impressively, the use of ketamine as an agent for analgesia and conscious sedation during battlefield-casualty evacuations helped to decrease mortality rate of wounded soldiers who made it to medical treatment from 4.5% during the Korean War to 2.6% during the Vietnam War. 

Critical early research on ketamine was performed by Edward Domino, MD, an American clinical pharmacologist. Domino was the first to discover that ketamine has multiple pharmacologic applications, including anesthetic, analgesic, and anti-depressant effects. Domino was also the first researcher who discovered the hallucinogenic properties of ketamine. These experiences were first labeled as “emergence phenomena,” but Domino’s wife famously coined the term “dissociative anesthetic” as a way to describe these effects without raising too many eyebrows from the establishment that would be approving ketamine for use in humans.

In 1970, the FDA approved the use of ketamine anesthesia with children, adults, and the elderly. Since that time, ketamine has been widely used in hospitals and for office procedures due to its rapid onset, short duration of action, and superior safety. Ketamine has now been used in clinical practice for fifty years. It has been continually used as an anesthetic to evoke general anesthesia, a first line agent to induce procedural conscious sedation, a potent non-opiate analgesic to control both acute and chronic pain, a unique neuroprotective agent to prevent brain damage, a superior anxiolytic to control preoperative and end of life anxiety, a rapid onset antidepressant to treat chronic depression and other treatment-resistant psychiatric conditions, and the only legal hallucinogenic drug available to conduct psychedelic psychotherapy.

Ketamine is included in the 18th edition of the WHO model list of essential medicines, promulgating its availability in a health system.

 

Ketamine and Psychotherapy

Edward Domino quickly discovered that “emergence phenomena” may occur independently of anesthesia and can be reliably generated by an administration of a subanesthetic dose of ketamine. At a rate of one-sixth to one-tenth of the dose used for general anesthesia, ketamine can create psychedelic experiences with disconnection from surroundings, perceptions of floating and disembodiment, and even dying and going to a different world. He also noted that loss of reality contact appears more pronounced than with other psychedelics.

It is precisely this disconnect that allows the brain to reset and open itself to positive change.

 

How does it work?

For so long, the main thrust of pharmacologic treatment for depression, anxiety, obsessive-compulsive disorder, and post-traumatic stress has been on increasing the amount of serotonin in your brain. This has been done under the presumption that deficits of the neurotransmitter serotonin in your brain leads to a dysfunction in mental health.

Research has revealed that we have many neurotransmitters. Serotonin makes up approximately 2% of those. Even more interesting is that serotonin comes from our deep (primitive) brain. Glutamate makes up greater than 90% of our neurotransmitters, and is employed by our frontal cortex—the thinking part of our brains. Glutamate is the neurotransmitter most affected by ketamine and it targets the NMDA receptor in the brain.

We have also learned that the term “chemical imbalance” is inaccurate. There is not a deficit of serotonin that results in depression and anxiety. 

By targeting glutamate and the NMDA receptor, ketamine therapy results in an immediate reprieve from depression and anxiety that has sustained results with cumulative treatments.

 

What does it feel like?

The ketamine dissociative experience is, in fact, a non-ordinary state of consciousness (NOSC), during which the individual’s awareness and perception are dramatically changed and radically refocused. This psychedelic experience is often induced by IM injections of Ketamine in doses that are typically used for dissociative sedation and lasts from 45 minutes to one hour. The patient loses contact with external reality and gets involved in a profound psychedelic experience. The ketamine-induced non-ordinary states of consciousness may include any of the following:

1. Feelings of leaving one’s body
2. Awareness of becoming a non-physical being
3. Emotionally intense visions
4. Visits to mythological realms of consciousness
5. Re-experiencing the birth process
6. Vivid dreams and memories 
7. Experience of ego dissolution, psychological death and rebirth of self, or of reliving one’s life
8. Deep feelings of peace and joy
9. Sense of transcending normal time and space
10. Feelings of interconnectedness with all people and nature, or of “cosmic unity”
11. Sense of sacredness
12. Profound sense of ineffability of the experience and an intuitive belief that the experience is a source of objective truth about the nature of “absolute reality”

 

What to expect?

After meeting with your therapist, an initial dose will be discussed and agreed upon. As a patient, you will inform us of your expectations of what you would like to discover and accomplish. The medication will be administered in the most appropriate fashion (sublingual, subcutaneous, or intramuscular). In about five to ten minutes, you will enter into a dream-like, non-ordinary state of consciousness. It is here where you will find therapy. This typically lasts 45 minutes to one hour. 

As you leave this state of mind, you will likely feel a bit euphoric and will want to ponder and journal about what you experienced. Your therapist will be by your side throughout the entire experience and help you to integrate what you learned, and then assist you in making real life changes based on your newly gained insight. 

The effects wear off in a predictable fashion in two to three hours after the dose has been administered, but we advise using rideshare or having a companion to drive you home, as you will be technically (and legally) impaired to operate a motor vehicle. 

 

Are you a candidate?

If you are already a patient of mine, then just ask. If you are a new patient, we can discuss ketamine as an option for you at our initial consult. Individuals with certain health conditions may not be able to receive this treatment.

When it comes to a contagious illness, preventing further complications, or just making a doctor’s visit possible with distance or mobility issues, telemedicine, also called telehealth services, is making it possible for patients to put their fears of making things worse to bed while still getting the help they need before things get worse. Call Hill Family Medicine for your telemedicine consultation!

The Benefits Of Telemedicine

• Reduced risk of complications to pre-existing illnesses from contact with the outside world
• Being able to set an appointment from anywhere
• Reduced risk of exposing others to your illness
• Faster turnaround time from realizing you need a checkup to getting one
• Studies have shown better long term health results for those who utilize telemedicine regularly

Telemedicine available with Hill Family Physicians

Hill Family Medicine in Bee Cave is excited to introduce telemedicine capabilities for our facility. Patients will now be able to set up appointments at our primary care center via the Doxy app. This offers an exciting opportunity for clients to see a doctor face to face via teleconferencing. It’s great for anyone feeling too sick to leave the home or who is not physically able to, and we’re proud to start offering them in the midst of the coronavirus crisis.

Telehealth services can be especially helpful for seniors who are at higher risk for complications or contraction of viruses, infections, and more. However, at this time we ask that any of our existing patients who are seeking out care for COVID-19 try to utilize our telemedicine applications before coming into our primary care facility. Some of the symptoms we’re referring to include:

• Fever or feeling the chills
• Cough
• Sore Throat
• Runny or Stuffy Nose
• Muscle or body aches
• Headaches
• Fatigue
• Vomiting and diarrhea (though mostly in children)

The Benefits of Telemedicine’s role in the Health care

Telemedicine is helping people reach health care services faster and easier than ever before, and now it’s available for our patients in Bee Cave and Austin who can’t make it into our care center. With our busy world, we understand if you don’t feel like you have time to come in for an appointment. Fortunately, with the advent of telehealth from Hill Family Medicine, you can get a check up from our local nurses and primary care doctors from anywhere. Contact us today to schedule your appointment!

Here at Hill Family Medicine, we’re passionate about providing high-quality care for our community. We want to promote health and wellness among our friends and neighbors in the Austin and Bee Cave areas, no matter their age or financial situation. That’s why we have an expansive list of accepted insurances to make accessing the primary care you need easy. We are proud to accept Medicare and Medicare Advantage because we know, as you or your loved ones get older, you’ll need more consistent care.

What is Medicare and Medicare Advantage?

Medicare is the insurance that is made available at a certain period of life to make the later years of life, when health problems often escalate, more affordable. Original Medicare is the most commonly known version of Medicare. Usually, when you turn 65 you’ll receive a form to sign up for Medicare and start getting health benefits from the United States government. However, there’s another program that is along the same lines that fewer people are aware of: Medicare Advantage. Both plans have to offer the same benefits, however Medicare Advantage often goes above and beyond the initial expectations people have for the average Medicare plan. Medicare Advantage often offers more coverage than the original Medicare and it’s separated by three key differences between the two programs.

Original Medicare

Original Medicare differs from its counterpart in a couple of major ways. Coverage is the biggest difference between the two programs and with Original Medicare you can often only expect medical and hospital costs to be taken care of only.

Additionally, the costs between the two plans differ as well. In the original Medicare plan you won’t have a cap on what you can pay out of pocket for a medical procedure. Original Medicare will only pay for a certain number of days in the hospital or at a skilled nursing facility. It does not provide long term financial relief for any serious ailments.

While the last point they differ on is rarely tested and is not widely known, Original Medicare does not cover costs of care that you receive while out of the country. Even in the event of an emergency. There are some exceptions to this rule, but there are not many. For this reason, it’s almost impossible to only have Original Medicare as the only health plan you have access to in your old age.

Medicare Advantage

Medicare Advantage is an excellent insurance plan if you can qualify for it. It rises about the coverage offered by Original Medicare by a remarkable amount. Most Medicare Advantage plans cover vision, dental, hearing, prescriptions and visits to medical facilities of all kinds. This means you won’t have to struggle to find a way to cover the cost of your medications or your appointments that you need to stay in touch with your doctor and stay healthy.

Medicare Advantage also has an out-of-pocket maximum each year that ensures you won’t have to pay an arm and a leg should something severe go wrong with your health. After you hit a certain dollar amount of out-of-pocket care, you won’t have to pay a single thing for the rest of the year!

Plus, if you like to travel, you’ll have coverage in the case of an emergency outside out of the country as well as inside the country! While you’ll have to wait until you get back into the states to access your primary care physician, you won’t have to worry about paying egregious amounts for any emergency care that you might need while abroad. This takes a huge weight off of most people’s minds and is one of the main reasons that Medicare Advantage is often chosen over the original Medicare plans.

Hill Family’s Medicare Programs

Here at Hill Family Medicine, we’re proud to offer exceptional care to folks all over the Austin and Bee Cave area. We provide a wide range of different care that you can access with either a Medicare or Medicare Advantage plan, depending on your needs and preferences. Check out our services available now!

Preventive Care Services

Having good health requires taking precautions. Health precautions can range from eating well to putting on sunscreen before you spend a day outside, but the most important precaution you can take is by scheduling regular preventative care appointments with your primary care provider. We provide a wide and comfortable selection of preventative care measures that you can take to remain healthy and happy for years to come. While some of our preventative care services include things like weight loss, risk factor assessments for strokes and heart disease, and skin cancer screenings, we can provide a selection of other care options, too.

For example, if your family has a history of diabetes or other disease that might be linked to being passed on through hereditary connection, we can create a plan that helps you combat potential future issues.

If you can get started now on keeping your mind and body sharp and healthy, you’ll prosper in the future.

Outpatient Care Services

Outpatient care is becoming an increasingly more attractive way to handle standard care procedures on the day-to-day. Luckily, here at Hill Family Medicine, we’re equipped to perform a selection of procedures as outpatient care options. Through our program, you can pursue exams and testing, mental and physical health treatments, and referrals to specialists in the area, all without having to stay overnight or make a bigger deal about a minor health issue.

Our outpatient care menu includes help with stress, skin sores and infections, urinary tract infections, eye injuries, cuts and bruises, test panels, vaccines and so much more. We want to be able to help you pursue the very best health that you deserve while still being able to go back home and recover in your own bed.

Telemedicine Services

With the COVID-19 pandemic changing the way we live our lives, telemedicine has become more crucial than ever before. What was once a matter of convenience can now be a life saving measure. Through telemedicine, people with pre-existing conditions can stay safe and sound at home while still accessing the care and professional advice they need in order to live a healthy, happy lifestyle.

Plus, it won’t matter where you are. You’ll be able to set a telemedicine appointment up while you’re in a foreign country, if you’d like to. Distance and traditional time frames won’t have to be an issue. For example, if you run out of a prescription while you’re on a long-term abroad trip, you won’t have to figure out how to live without life saving medication. You can simply set up a telemedicine appointment and access the refills and supplies you need to continue your trip as planned.

You’ll also be able to reduce your own risk of exposure to other illnesses as well as other people’s exposure to a potentially contagious disease you’re carrying. You’ll be able to get the answers you need and the care you need all from the comfort and safety of your home without endangering yourself or others.

We proudly offer our telemedicine services to Medicare Advantage and Medicare insurance carriers as we know that, as you age, it can get harder to get out of the house on your own. Instead, you’ll be able to connect with your doctor, discuss your symptoms, and find a course of action, all while remaining comfortable and happy, right where you are.

The term “preventive care” is an overarching term that encompasses everything that you generally visit your GP for. Treatment and diagnosis are often included in a GP visit, unless you need to be referred to a specialist. However, that trip to the doctor you make on a yearly or bi-yearly basis is all about preventive care, though the term isn’t often thrown around in regard to your visit. So, just what is it and how can you start leveraging your yearly doctor’s visits to start creating an excellent preventive care plan that’s tailored just to you? Take a look.

What is Preventive Care?

Preventive care is defined as health care that targets and shifts your current health trajectory. In other words, it’s a health care practice that recalibrates your health goals and helps you develop healthier habits. Once you’re relatively healthy, your visits to the doctor should become more about maintaining wellness and increasing your good health more than anything else. It’s there to ensure that, before you feel any unpleasant symptoms or have to have a treatment plan designed, you’re already taking steps to prevent those issues as you go. Preventive care doesn’t just cover a guideline for a healthy lifestyle though, it also includes other services like screenings, lab tests, counseling, immunizations and much more. All of these different aspects are designed to make life easier and to prevent future illnesses before they become a real problem.

Treatment options for any ailment can be categorized into two sections: inpatient and outpatient care. As a patient, you’ll need to know the difference between the two so that you can make a decision on what kind of care you’d prefer and what your doctor thinks you need.

Here at Hill Family Medicine, we’re dedicated to helping you access the type of care you need. We strive for clarity and transparency in all that we do, which is why we make understanding your care procedures so readily accessible.

Explore our outpatient services and why you may need outpatient care in the future

What is Outpatient Care?

Outpatient care is a medical service that doesn’t require the patient to stay at a facility. Indeed, it’s a type of care that saves people thousands of dollars a year in medical care costs. Outpatient care can be anything, including procedures, services and tests. As long as it doesn’t involve an overnight stay in the hospital, it’s considered an outpatient service. Thanks to medical advances, there are more and more services that can be done as outpatient care.

Examples of potential outpatient services:

• Wellness & Prevention
• Diagnostic Service
• Long-term Treatments
• Rehabilitation

What is the Difference?

Inpatient and outpatient care are, still, often a choice you can make when trying to find the best care options for you. They’re extremely different types of care services, and which one you choose should depend on a variety of factors. Many folks believe that it’s entirely up to the doctor on whether you have to do those tests and pursue that care in the health care facility and overnight, or whether you can go home that day. There are three major differences in inpatient and outpatient care that determine most people’s ultimate decision on which they’d like to use: Cost, comfort level, and convenience. Obviously, the ability to treat an ailment as an outpatient or inpatient issue relies largely on the ailment itself and the kind of care you need. However, thanks to medical technology improvements and the benefits of outpatient care over inpatient care, there are more and more ailments that can be treated with outpatient care. After all, wouldn’t you like to get the procedure done and then go home to your own bed?

Cost

The best benefit of outpatient care, by far, is cost. Going into the hospital and having an overnight stay costs a lot of money and time. If you could accomplish the same thing with a simple visit to your primary care physician and achieve the same results, why wouldn’t you do that? The tests will likely cost what they’re going to cost, but there’s no reason to run extras simply because you’re there, sitting in a hospital bed. For most, outpatient care targets the issue and allows the doctor to rule out other ailments and pinpoint the real issue in much less time for much less money. If you were to, for example, have an overnight stay to assess your low-grade insomnia and find ways to address it, you’d end up paying thousands of dollars for the observation, and for the same tests that your doctor would likely have you conduct on your own or with a trusted loved one.

Rather than over-complicate your care and force you to pay more for it, outpatient care provides a wide array of options that cost less and are more simple and elegant in nature.

Comfort Level

When you’re sick and uncomfortable, all you want to do is stay home and stare at a wall. Getting treatment for your ailments, however, often involves a long and arduous trip to the doctor’s office and can sometimes escalate past what’s really needed. If you could, wouldn’t you rather have the option to heal up in the safety and comfort of your own home? Outpatient care gives you the opportunity to do that without too much fanfare. Our outpatient services get what you need done completed quickly and efficiently so that you can go home, recover and feel the effects of the treatment take place in only a couple of days.

It’s an excellent way to limit the discomfort of getting treated for an illness you simply didn’t plan on having.

Convenience

Beyond the other benefits of outpatient care, it’s also far more convenient than any inpatient care solution might be. Getting treated for mental health issues, infections and having testing done is all a big enough pain to get out of the way as it is. If the ailment is more serious, it’s going to be even more unpleasant to pursue these same treatments while suffering more than usual. Outpatient care has grown extremely popular because it allows health care providers to not waste your time or theirs on unnecessary precautions, like holding you overnight when you’re fine to go home. Or, for example, not referring you to the hospital when the same tests can be completed and used to draw conclusions from a primary care office.

Time is, above all else, our most valuable resource. So, if there’s a way to save time and still get you the treatment you need, we’ll always choose that option.

Outpatient is On The Rise

Get Healthy And Get Your Confidence Back

At Hill Family Medicine in Bee Cave, we know that every client’s healthcare needs are different, so we strive to provide the best possible solutions for many concerns, including weight loss. We’re happy to offer cutting edge and customized weight loss techniques for all of our clients, after all, keeping your weight in a healthy range is a critical component to addressing other factors of your primary care.

Here are just a few of the many health problems that have linked to being Overweight or Obese.

• High blood pressure
• Diabetes
• Heart Disease and Related Ailments
• Cancer
• Sleep Apnea
• Gallstones

With heart disease, cancer, and many other life-threatening conditions occurring at high rates with those who are overweight or obese, those who are significantly overweight can be up to twice as likely to die prematurely. If you want to live your best life, for the longest time possible, then you need to take measures to ensure you’re in a healthy weight range.

If you’ve been stuck at an unhealthy weight or in a body that makes you feel uncomfortable from day to day, then we can help, with treatments and plans to help you increase your metabolism and boost your mood. Our weight loss programs work by resetting your metabolism through a combination of lipotropic injections and lifestyle changes in order to spur weight loss and fat removal from some of the most challenging areas, such as the stomach or hips.

Based on the latest in medical science, Dr. Matthew, our resident primary care doctor, builds a fully customizable plan for each patient. Plans include weekly monitoring, as well as lipotropic injections at Hill Family Medicine. Plans may or may not include various prescription medications, and/or specialized diet plans. Initial visits always include the following:

• Initial Upfront Lab Work 
• Complete Medical History
• Daily Habits and Things To Improve On
• EKG

The beauty of our program is that it’s non-surgical, non-invasive weight loss, and far from a gimmick. We won’t tell you that our weight loss programs require no work, but we’re confident that if you dedicate yourself to our treatment plans, then we can provide the easiest weight loss of your life. If you need to get your health in check, you want your body to look better, or you’d simply like to feel better on a regular basis, then our medical weight loss programs can help. Call or come into Hill Family Medicine in Bee Cave today to learn more about medical weight loss.

What Causes Allergies?

When your body categorizes an allergen as harmful, it produces antibodies for that allergen. Each time you encounter that allergen in the future, the antibodies attack the allergen and produce chemicals like histamine that cause allergy symptoms.

Common Allergies

• Latex
• Medications (Such as Penicillin)
• Insect Venom
• Specific Foods
• Pollen
• Mold
• Dust Mites
• Animal Dander

What Causes Allergies?

The purpose of your immune system is to keep the body safe by recognizing and attacking foreign substances, such as viruses and bacteria. When you have allergies, that means there’s a malfunction in this process.

An allergy develops when the immune system mistakes a harmless substance for a harmful one. When the immune system attacks the allergen, you experience allergy symptoms that may affect your skin, digestive system, airways, or sinuses.

Common Allergy Symptoms

The symptoms you’ll experience when you have an allergy usually depend on the type of allergen. For example, inhaled allergens, such as pollen, may cause watery eyes, a stuffy or runny nose, itching in your nose or roof of the mouth, and sneezing.

For allergens that you eat or swallow, you may experience more severe symptoms, such as:

• Rash
• Itchy Skin
• Hives
• Wheezing
• Facial Swelling
• Diarrhea
• Nausea
• Skin Allergens:
• Rash
• Itching
• Flaking

How does Hill Family Medicine & Skin Care Tests for Allergies?

For most types of allergies, our practitioners will recommend a blood test or allergy skin testing. This test can determine which substances are causing your symptoms so you can get the best possible treatment.

Allergy Treatments

With some allergens, you may be able to deal with the problem simply by avoiding the substance. However, other allergens are unavoidable. Some allergies respond well to medication, such as antihistamines.

However, if you continue to have symptoms with medication, immunotherapy may be recommended. We can treat you with a purified form of specific allergens over a period of several months. That will help you build an immunity and experience fewer symptoms down the road leading to less illness due to allergies and less need for allergy medications.

Symptoms Indicative Of Allergies

• Stuffy or Runny Nose
• Sneezing
• Itchy and Watery Eyes
• Dark Eye Circles 
• Rashes
• Coughing
• Wheezing

Hill Family Medicine is now offering allergy testing and immunotherapy onsite in our Bee Cave location.

Discover immunotherapy treatment for effective allergy relief.  If you are interested in allergy testing and think allergy drops may be right for you, call our office at 512-428-5764 for more information.