Treating Mental Health Differently | Dr. John How

**Dr. Gabrielle Lyon** (0:00)
Welcome to The Dr. Gabrielle Lyon Show, where cutting-edge science meets innovation and practical application for everyone. Dr. John How, an accomplished emergency room physician, and through his own experience with burnout and the demands of being a physician, found a procedure called the Stellate Ganglion Block. He is now an advocate for the treatment of PTSD, depression, and anxiety with multiple modalities. Join me in this conversation with Dr. John How. Dr. John How, welcome to the show.

**Dr. John How** (0:34)
Thank you.

**Dr. Gabrielle Lyon** (0:35)
I'm really excited to chat with you and funny story. Do you actually know how I got connected to you?

**Dr. John How** (0:41)
No, tell me.

**Dr. Gabrielle Lyon** (0:42)
We had Dr. Eric Wan on the show and he was talking about trans-magnetic stimulation.

**Dr. John How** (0:51)
Right.

**Dr. Gabrielle Lyon** (0:52)
And I have a very good friend that I needed to facilitate a Stellate Ganglion Block for.

**Dr. John How** (0:57)
Sure.

**Dr. Gabrielle Lyon** (0:58)
And this is, which you're going to talk all about, how we manage trauma, PTSD, anxiety, depression. Without largely medications, but an actual procedure that may provide long-term benefits. So anyway, I called him and he said, well, you got to go to this guy. And here we are.

**Dr. John How** (1:19)
Wow. I'm glad to be here. I'm glad we made the connection. It's awesome.

**Dr. Gabrielle Lyon** (1:22)
Same. And I was looking at some of these statistics. I was looking at statistics on depression, treatment-resistant depression, again, PTSD. Your numbers were a bit even more impressive than the ones that I have, but I'm just going to lay this out here. 280 million people in the world suffer from depression. depression is about 50 percent more common among women. The men.
treatment-resistant depression, meaning they failed multiple modalities. That is we are looking at 30 percent of people with depression meet that definition. PTSD. One half of all US adults will experience at least one trauma event in their life. Most of them do not develop PTSD.
10 percent of Americans will develop PTSD, and we know that that's much higher in our military population.

**Dr. John How** (2:23)
Totally.

**Dr. Gabrielle Lyon** (2:24)
Before we talk about all of these things, please tell me a bit about your personal journey in medicine. You were an ER doctor. Now you have a clinic that does both regenerative and Stellate Ganglion Blocks.

**Dr. John How** (2:40)
Yeah. Well, first of all, thanks for having me. I really appreciate it. As you said, I'm an ER doc by training.
And I did that job for a long time. It's a great job, but it wears on your body and your mind. And I started looking for other things to do. One of the things I love doing, or when I was working in the emergency department, was using the ultrasound for diagnostics and for procedures. We do a lot of nerve blocks in the ultrasound, I'm sorry, in the emergency department.

**Dr. Gabrielle Lyon** (3:08)
For pain?

**Dr. John How** (3:08)
Yeah, you break a hip, you break a rib, we'll put some medicine in there to make it so that pain is less. Or if we need to sew something up, or if this is a broken bone, anyway. Yeah, so then I started leaning into that passion and getting more training on doing those blocks. And that led me into studying how to do regenerative medicine. Now, as you know, regenerative medicine is taking, usually it's an ultrasound guided procedure of some sort, putting a product that we either get from the body or get it somewhere else into an area of the body, a joint, a tendon, a ligament that's inflamed, irritated, torn, and triggering the body's response to try to fix it. So learning how to do that, hundreds of hours of teaching with that, going to courses, finding people that know how to do it. Part of that training was learning how to work on the neck. Now, there's a bunch of nerves, as you know, in the neck. You got to know the anatomy pretty well to work in the neck. So part of the training for that was, hey, listen, there's a stellate ganglion, or there's a sympathetic chain is here, that's something that some people do for this thing called PTSD. Great, fine, whatever that is. I'll learn how to do it. Didn't think much of it. I felt super skeptical about the fact that a shot in the neck could help PTSD significantly. So I'm going along living my life, learning more things about the regenerative medicine side of things. And then I started noticing that some of the things that personally I was dealing with from a mental health standpoint, the symptoms are lining up a little bit with PTSD. So increased irritability, difficulty with focus, difficulty with sleep, those kind of hyper arousal symptoms that we see with PTSD. So one thing led to another. I went to the guys that were teaching me how to do this. I was like, hey, can we do the thing and see how it goes? And I had it done and holy smokes, it was the coolest thing ever. And from then on, I'm like, well, that's the coolest trick in medicine. I need to be doing that on a regular basis.