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Angela Rose (Host): Hello and welcome to another episode of the survivors.org podcast. This episode is sponsored by Color Street Nails and Color Street is a creative beauty brand with limitless possibilities.

I'm your host, Angela Rose, the founder of PAVE, Promoting Awareness Victim Empowerment. And I am thrilled to have with us today our friend, Dr. Eugene Lipov. He's a physician researcher and board-certified anesthesiologist who specializes in intervention-based pain management. Born in the Soviet and controlled Ukraine, Lipov and his family immigrated to the United States in 1973. He's best known for his treatment of PTSD, post traumatic stress disorder, using the stellate ganglion block, otherwise known as SGB. Welcome, Dr. Lipov. Thank you for being with us.

Dr. Eugene Lipov: Thank you very much for having me.

Angela Rose (Host): So one thing that really struck me as I learned about your work is how effective this treatment is to treat PTSD. Can you talk a little bit about how you discovered this and a little bit about your work?

Dr. Eugene Lipov: Oh, absolutely. Again, thank you so much for giving the opportunity. Actually, it all started with me trying to treat people with hot flashes, women with hot flashes, especially breast cancer. And we were having really excellent results and I was able to publish in big medical journals. But there was a lot of debate, shall we say, in medical circles why it works, because I had no idea why it worked at all.

Through interesting set of circumstances, I found an article from Finland where they were doing clipping in the chest, taking away hand sweats, and they found that PTSD went away. So then I looked at that anatomy. It turns out the same thing can be done by a simple injection in the neck, instead of doing something more in the chest. And we treated our first patient about 16 years ago. That gentlemen was robbed at gunpoint and he was on his way to be admitted to the psychiatric ward. We treated him and he didn't need to be admitted and how it all started.

Angela Rose (Host): That's incredible. And we talked to Linda Vester on a previous episode of our podcast, and I was so inspired to hear that that treatment, she said, literally changed every aspect of her life. And I had watched a couple of videos from other people that have been treated with this type of injection. And so one thing I want people to understand is there really isn't any like after-effects. There really isn't any negative consequences. Can you speak to that? Have you seen anything negative after a treatment like this?

Dr. Eugene Lipov: Well, given I'm an invasivist, so I do injections all the time, so you always have to be careful. So if it's done correctly, the chance of problems is extremely remote. But if, for example, local anesthetic is being injected into an artery, that'd be problem. But that's why we use guidance. We use ultrasound guidance and we can stay away from blood vessels and lungs and things like that.

There may be some discomfort, but that's pretty much it. So historically, I've done stellate ganglion block for 35 years. First, we started blind, we didn't have guidance, and we had x-ray. Now, it's ultrasound. And I personally have not had issues, but it's possible to have issues. Again, extremely remote, knock on wood.

Angela Rose (Host): That's right. And so I would love to dig a little bit deeper. So for people that are listening or watching, that might not understand PTSD, I suffered from post traumatic stress. So it's like that fight or flight was always kind of on guard. Can you talk a little bit about some of the PTSD symptoms that, you know, some of your patients have had and how those have been eliminated?

Dr. Eugene Lipov: Yeah. So if you don't mind, I'd like to tell you what PTSD is and what it's not. First of all, I really dislike the term PTSD. So Dr. Frank Ochberg, my friend, who is an amazing psychiatrist, came up with the term for Stockholm syndrome, you may have heard that. But he believed name should be PTSI, post-traumatic stress injury, meaning it's a biologic change in the brain that it's visible on special scans, which are available now, such as PET scans and fMR and things like that.

So basically, what happens during severe stress or multiple stresses, fight and flight system gets stuck on on position. So, what this block seems to do is reverse that. So specific symptoms, you unfortunately had to go through that, symptoms such as sleep disorder, difficulty sleeping, nightmares, things like that, impulsivity. So if somebody touches you on the shoulder, you jump out of your skin and always waiting for the next shoe to drop. Those are all very common symptoms. Many times they go away in about 10, 15 minutes after procedure. Some of the most interesting stuff that I've seen as people say, "I see color for first time in years."

Angela Rose (Host): Wow.

Dr. Eugene Lipov: It wasn't vivid. Now, it's normal, beautiful vivid colors. And then, a number of people say, "I can never take a deep breath because of PTSD." While after the block, a lot of people actually take a deep breath, which is really amazing to see.

Angela Rose (Host): Wow. let's dig a little bit deeper on how this works, so biologically and neurobiologically. Can you speak to how this does help to alleviate these symptoms?

Dr. Eugene Lipov: Yeah, of course. Again, back to what happens, let's say there is a severe event, whatever that event is. And that part I very like about my approach to it, a lot of people who are survivors and people who have been through a lot of horrible things, they really don't want to relive that again. They don't want to talk it. So when we do our procedure, we do not ask about the event. There is no need to know what happened, how it happened, how often. It makes no difference to me and the other people you see them go, "Oh my God, I don't have to go through that again." But physiologically, what happens is event happens, fight and flight system from the neck is activated. So the brain activates nerves in the neck. Then it basically starts to produce more norepinephrine, which is like adrenaline, brother of adrenaline. It also produces something called NGF, nerve growth factor. That's produced in the brain and has been shown to be brought from the brain down to the neck, through the nerves in the rat model. Once it happens, instead of having four nerves, sympathetic nerves, fight or flight nerves, now let's say you have eight. There's extra nerves. And as long as you have extra nerves, it produces more norepinephrine. So if you take the fluid around the brain from soldiers with PTSD or survivor, they will have increased norepinephrine levels.

So as long as that state of affairs persist, people have PTSD. It could be years. So when we do the block, it does two things. One, it stops secretion of norepinephrine immediately. So in 10 minutes, people go, "I feel so much better. Thanks, doc," so that's one. But two, it reduces NGF. So NGF is required to maintain instead of four to eight nerves, so now it goes back to four. So now, a block that lasts eight hours can last for years.

Angela Rose (Host): Wow. That's powerful. You know, a lot of the survivors that we've talked to over the years, like one of the aspects of PTSD for them is triggers. So things that aren't a danger or a threat, but that their parasympathetic nervous system feels a threat. So for example, for me, if there was a shadow or somebody walking behind me, I would constantly feel like there was somebody approaching me because of the trauma that I went through. So do you feel like this treatment helps people that have been through PTSD in terms of the triggered response? You know, that hairline trigger response that so many survivors have where there's something that we think to be a threat or we feel is a threat, even though it's not a threat to us.

Dr. Eugene Lipov: Absolutely. That's the whole thing. So let's talk about what actually happens physiologically if you don't mind.

Angela Rose (Host): Please.

Dr. Eugene Lipov: So there is a part of the brain that's called the amygdala, it's a fear center for the lack of better word. So if you look at the animal, like antelope let's say in a prairie, they hear a sound, amygdala lights up and you start running. You don't even know there's a tiger or whatever, it's just it's on, you're running, right? Because that's a defensive response. As a human being, we are a little more sophisticated. We can interpret things, but not that much different to me. Because if you see something back out of your corner eye or somebody behind you and you don't know that person, your amygdala is going, "That is no good. This could be the same thing that happened in the past." And now, once the amygdala is unhappy, that's my technical term, it activates fight and flight system. So now you feel tightness in the chest. You feel your heart rate increase. You're getting ready to run. The same thing as the antelope. And I had my own symptoms like that. I don't if you know that. I had my left side stellate done two weeks ago. I had my right side done number of years ago, but I had a complex childhood, shall we say. So it felt to me like my heart was being squeezed. Anytime something reminded me of something that happened in the past.

Angela Rose (Host): Wow. Thank you for sharing that. That's so powerful. And you spoke briefly about kind of having it on both sides of your neck. Can you speak to why that's important? Do you think that's true for all of your patients? Or do you feel like that's only true for more complex childhood trauma, to have it on both the right and the left side?

Dr. Eugene Lipov: It depends. We're still studying that. So I'd like to be able to predict it, but we're not quite there yet. We're about to start doing a massive study to evaluate that in New York City. right side, it seems to work. Right-side injection seems to work, let's say, 80%, 85% of the time. And again, I don't know that for a fact. But it seems if there is childhood trauma and adult trauma, it seems to be controlled right and left side. If it's adult trauma, a lot of times the right side is enough. So basically, the way we treat it, it's symptomatic. If we do an injection and people feel great, there's no reason to do anything. If they don't and they still have some stuff that hasn't worked and there's childhood stuff, then we do both. And then what we find, which is interesting, after this, people do know when it's changed. A lot of times is their family members know what's changed, which is great. But the other part is that psychologists really love us because now they can actually discuss what happened instead of people being overly triggered.

Angela Rose (Host): Wow. That's so powerful. And I love your work with the Erase PTSD Now. So for folks that can't afford this procedure, can you talk a little bit about the work at Erase PTSD Now?

Dr. Eugene Lipov: Yeah. So Erase Now basically is a 501(c)(3), which I actually formed 2009. We have an amazing executive director and amazing board, led by a green beret colonel. So we are very proud of what we are trying to do. So part of our job is to treat people and then to keep track of it and research and publish and things like that, because ultimate goal is to be acceptable and available for everyone. We are currently restructuring their input criteria, because we've had an overwhelming response and, you know, unfortunately, we can't treat everyone. So anybody who would like to donate, obviously no donation too big, no donation too small. So when people ask me how much money do I want, I say, "How many people do you want to help?" One, two, quarter, thousand? Everybody has a different capability.

Angela Rose (Host): That's right. Oh, that's so powerful. And we are so excited for the work that you're doing. And I think what's really interesting is that you spoke to this a little bit that with PTSD, it doesn't have to just be survivors. I mean, I watched a video of a woman that you helped that was assaulted at her job. She was a nurse and she had a really horrific thing happen. And the way that she talked about this was that this whole weight had been lifted off of her chest and that her life had been completely changed because of this treatment, this injection. So can you just speak briefly to the fact that there are so many different types of trauma that it doesn't have to-- I mean, it could be somebody coming back from war, it could be a survivor of sexual violence. There's so many different aspects to trauma. So can you maybe speak to the fact that PTSD can happen to anyone?

Dr. Eugene Lipov: Yeah, I actually do better than that. I have a publication on that from this year. I can send it to you. So what we did looked at 22 different types of trauma, and we wanted to see if certain type of trauma responds or certain type of trauma does not respond. So out of 22 types of trauma, which was military, sexual abuse, neglect, unfortunately all type of horrible stuff happens, everybody responded, which is great. But the other thing is we are actually writing a paper with a very famous neuropsychiatrist, and we looked at the brain scans of different types of military, military spouse, which is called secondary PTSD is one of my many passions. Also, somebody who was falsely incarcerated and then his wife, also secondary PTSD and the brain scans look pretty much the same. So the bottom line is, you know, I think this whole concept that there is trauma that should be acknowledged and trauma shouldn't be acknowledged, I think that's a ridiculous perspective. There's no difference to me. When I was in the county and people came there were injured policemen or somebody out walking in the street or attack victim, everybody believes the same. There's no difference.

Angela Rose (Host): I think that's a really powerful thing for survivors to understand, too, that like you mentioned in brain scans, change the brain. And I think for survivors to understand that, because there's so many questions like, "Well, why do I feel this way?" or "Why am I acting this way?" You know? And like you said, families are impacted when we go through trauma. It's difficult on the entire family when people go through trauma. So I love when you talked about how there is real things happening in our brains that change after trauma. I don't think enough survivors understand that. Would you agree?

Dr. Eugene Lipov: Oh, a hundred percent. The other thing, and that's part of our job in Erase PTSD is education. Let me just tell you another thought. So for example, my grandfather was involved in pogroms in Ukraine. So his DNA change. It's called epigenetics. We don't have enough time to discuss specifics of that. He gave it to my father who then was involved in World War II and there were horrible things that went on. So when he came home, he gave PTSD to me, my brother and my mother, which led to an eventual by my mother when I was a surgical resident. So you see not only is it trauma, but also your actual DNA gets changed. And the whole concept, it can go two, three generations. You can trace it out on a DNA, 66 Val substitutions. They can actually see all the paper on that as well. But it's very interesting that absolutely it's a biologic phenomena. And saying to somebody, "It's all in your head. You're hysterical," all of that I think it's crazy. Just as as an aside, I was giving a lecture and in Harvard, I picked up a book that's called History of Hysteria. You know, the original treatment for hysteria, first of all, it's called hysteria, because hyster- meaning it can only be in women. certainly met many men who was hysterical, especially in the trauma unit.

Angela Rose (Host): Right.

Dr. Eugene Lipov: But the original treatment is fumigation of the uterus.

Angela Rose (Host): Oh, my goodness.

Dr. Eugene Lipov: I would describe to you what that means, but I think we need to let that go. I think it's time to move on to the biological reality. And there's no difference with trauma. Trauma causes the same thing. If you get a broken arm, it doesn't matter if with a sledgehammer or a bullet, broken arm, it doesn't matter, still fix it.

Angela Rose (Host): I've always been really fascinated. And thank you for sharing your own experience. I've really been fascinated by the notion of epigenetics, because I love the idea of sort of breaking that cycle. And so for somebody that wants to break that cycle and is it possible for us to stop that in a generation of breaking that cycle of epigenetics when it's in our DNA?

Dr. Eugene Lipov: Yes, it is because epigenetics is not mutation. Epigenetics is activation of gene. So Dr. Blackburn, amazing researcher from New Zealand was able to demonstrate epigenetic reversal of trauma trauma byange my meditation.

Angela Rose (Host): Wow.

Dr. Eugene Lipov: It is reversible. That's a whole thing. In fact, we're studying that right now in a big university study, starting next month.

Angela Rose (Host): That is amazing. Thank you so much for all of your work. And for anyone listening, I think it's so important for us to realize that healing and living a happy, joyful life after trauma is absolutely possible. So please visit Erase PTSD Now. You can donate, you can educate yourself and learn more information about this wonderful work. And I just want to remind all of us before we close to love yourself, support each other, and together we can change the world. Thank you so much for being with me today.

Dr. Eugene Lipov: All true. Thank you.