The Ketamine Infusion Experience
After it is deemed that you are a candidate for a ketamine infusion based on proper evaluation, you will be scheduled for your infusion. Do not eat or drink 6 hours before the procedure except for small amounts of water up to 2 hours before the procedure. The total time that you will spend at the surgery center for your infusion may be up to 5 hours. This is not a 30 minute injection bolus “infusion” by a nurse like many other “ketamine infusion clinics” scattered throughout the country (including at least one in Illinois). This is also not a “ketamine coma” like some larger institutions still ignorantly perform. Our infusion is the real deal. It is an authentic, non-counterfeit, legitimate ketamine infusion administered by Dr. Joshi himself. We created our protocols and have led the country with our understanding of the infusions, our customized protocols, our educational programs, our low costs, and our hands-on approach.
Once at the surgery center, you will register just like you would with any other procedure or surgery. The intake process is thorough because we take details seriously. You will then be placed into private areas of the surgery center. We do not place patients into closets or all in one non-private area, like some other providers. The infusion experience is highly personalized. We use medical grade hospital beds for the infusion. You will not need to disrobe or put on a hospital gown. Usually, we allow one family member or friend to stay with the patient during the infusion. Standard ASA monitors are used throughout the infusion. An IV will be started and the infusion pump, flush, and rehydration tubing will be attached to the IV.
Once the infusion starts, we lower or turn off the lights and request calm and silence. Some patients chose to have ear plugs. Other patients chose to have calming music. You will be monitored throughout the infusion by both Dr. Joshi and his nursing staff. Appropriate real-time adjustments are made based on current and predicted responses to the infusion.
Side effects that could occur during the infusion can include nausea, blood pressure increase, heart rate increase, confusion, blurry vision, and hallucinations. Proper adjunctive medications are given before and during the infusion to help prevent or even avoid these temporary side effects. Dissociation may occur during the infusion as well, but that is not a side effect. Rather, it is the effect that ketamine has on the central nervous system. It is this dissociation of the NMDA receptors (and other receptors) that causes a “reset” of the pathologic neuroplastic changes that have occurred in the patient’s central nervous system.
Most, if not all, side effects resolve within 20 minutes after the infusion is complete. Some patients may feel tired that day or the next day, similar to regular anesthesia for other procedures. It is required that you have someone you know drive you home after the infusion.
Contrary to laymen belief, virtually all patients will say that they do not like the actual ketamine infusion. However, the pain relief can be so dramatic that they are willing to undergo a few hours of inconvenience for weeks, months, and sometimes over a year of relief. Most patients find the experience relaxing and pleasant, however, some patients with an underlying anxiety may have some unpleasant dreams during the infusion. The best outcomes are seen when patients relax during the infusion and focus on goals for improvement.
It is important to note that while we have seen 100% improvement in symptoms right after a ketamine infusion, those results will most likely not last forever. In many cases, it has taken years to aberrant neuronal changes to cause the central sensitization. Ketamine infusions can be highly effective in the management of these changes. It allows patients to get ahead of the pain and rehabilitate their mind and body. The reduction of pain allows patients to think more clearly, exercise and be more active, lower medications, reduce or reverse depression and anxiety, and return to a more normal lifestyle. The goal is to return to the preinjury or pre-disease central nervous system.